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A forty-five-year-old man with a three-year history of cardiovascular disease has entered the hospital with a stroke that has paralyzed his right side and caused him to aspirate food of any consistency.
His language capacity is only “yes” and “no,” and his responses are inconsistent. Jay attempting resuscitation following a pulmonary arrest was not likely to succeed.
The doctor further explained that even if resuscitation restarted his lungs, Mr.
Coronary angiograms of his left and right coronary artery are shown in Videos 1 and 2, respectively.
Figure 1 Serial axial images of the computed tomography with intravenous contrast showing the dissection flap limited to the proximal ascending aorta and the aortic root.
The majority of these patients do not experience return of spontaneous circulation despite resuscitative efforts.
In summary, aortic dissection is a rare cause of out-of-hospital cardiac arrest.
There is a high chance that the disease will progress to acute myeloid leukemia (AML), with lower chance of survival, so physicians had started chemotherapy. Over the last month, she has experienced increasing pain that has not been effectively controlled by her physician. He is not brain dead, but after 4 weeks in MICU and several neuro consults, the prognosis for “meaningful recovery” is said to be less than 1%.
This leads to other treatment decisions and dilemmas which become ethically complex. She has now been referred to hospice, primarily to get her pain under control. I had no experience on which to base my unsettling suspicions. JD has not regained consciousness and is apt to remain permanently in a vegetative state.
When Patti’s husband didn’t respond to attempts to contact him, with no advance directive, it was deemed more helpful to support the care team’s communication efforts and to provide an ethics perspective with procedural recommendations and “what if” options. is a retired teacher who is suffering from Alzheimer dementia, who lives in a nursing home. Her brother gives consent for her to be transferred to a hospital to discover what is going on, but after they have run a lot of tests, he asks, "Why are they doing all this? W is a sixty-year-old African American woman with a recent diagnosis of breast cancer with metastases to the bone and lung.
Patti, a 52-year old woman with history of asthma, chronic obstructive pulmonary disease, hepatitis C and substance abuse, presented to the emergency department after cardiac arrest at home with subsequent return of spontaneous circulation.