As hospitals across the country face shortages personal protective equipment due to coronavirus the patients, health health professionals would privately discuss the possibility of a general policy of non-resuscitation for infected patients in order to mitigate the risks for those who respond to a blue code.
“If we risk their well-being in the service of a patient, we harm the care of future patients, which is unfair,” wrote bioethicist Scott Halpern of the University of Pennsylvania in a model directive released, according to the Washington Post. However, he declared that a general policy of non-resuscitation for all COVID-19 patients was too “draconian”.
He suggested that the patient’s doctor and another sign the resuscitation orders on a case-by-case basis for patients with coronavirus, giving the family the reason – although they disagree with this.
Richard Wunderink, medical director of intensive care at Northwestern, said that many families choose to sign DNRs when hospital staff explain that having to wear protective equipment before treating a “coded” patient decreases chances of saving their lives.
“By the time you are all in your gowns and double gloves, the patient will be dead,” said Fred Wyese, an intensive care nurse in Michigan. “We are going to code the dead. It’s a nightmare.”
Doctors take an oath to do everything they can to save a patient’s life, but as COVID-19 cases escalate, the necessary PPE shortages force healthcare professionals to ethical dilemmas.
“We now face difficult choices in how we apply medical resources – including staff,” said Lewis Theplan, president of the Society of Critical Care Medicine and surgeon at the University of Pennsylvania.
When a patient “codes”, which means they have entered cardiac arrest, all available staff respond to the blue code to perform CPR and other rescue measures.
“It doesn’t help anyone if our doctors and nurses are killed by this virus and are unable to take care of us,” said R. Alta Charo, bioethicist at the University of Wisconsin-Madison. “The code process is one that puts them at increased risk.”
Often dozens of masks, dresses and gloves can be used in the process.
“It is extremely dangerous in terms of risk of infection because it involves several bodily fluids,” an unidentified ICU doctor told The Post.
At George Washington University, they use a machine to perform compressions on a coded patient, but since there are only two available, emergency hospital staff will place a plastic sheet over the patient as a barrier before start CPR.
“From a safety perspective, you can argue that the safest thing is to do nothing,” said Bruno Petinaux, GW’s medical director at The. Publish. “I don’t think it’s necessarily the right approach. So we decided not to go in this direction. What we do is what can be done safely. “
Any potential non-resuscitation policy should be carried out in accordance with state law.