17: Expectant Patients and Palliative Care

Despite our best efforts, endless training, and reading, some of our patients will die.  This has been a taboo subject that is difficult to broach in the best of times.  We aim to start a conversation here with the hope thatit continues with your Medical Director, PA, Surgeon and fellow Medics before you are ever faced with this difficult situation out on your own.  Often prolonged field care involves treating the most critically sick or injured patients longer than you expect to.  Inevitably some of these "sickest-of-the-sick" will not make it in time to see definitive care and you will be left to ease the suffering during end of life care alone.  While you may have to deliver end of life care by yourself, you may not have to make all the decisions alone.

In this episode Dennis and Doc Powell discuss how to treat expectant patients.  This could be as part of a multi-patient MASCAL or a happen to a single patient who is critically ill or injured.  If it happens during a MASCAL, once you are done treating your urgent patients, what do you do when you go back to your expectant patients?  It's common to skip over discussing and training on losing patients...  Taboo even.  The fact is that it will eventually happen; No matter how good of medics we are, patients may die.  Doc Powell has spent innumerable hours in Intensive Care Units with the best and brightest medical teams a patient could hope for.  Often in this setting the top notch care, medicines and interventions are not enough and patients code and die.  This is part of medicine whether we talk about it openly or not.