Case Study: Communication in an Emergency
Mr. Walsh is a 68-year-old man who was admitted to the cardiac care unit (CCU) 2 days ago after a myocardial infarction (MI; “heart attack”). It was determined that he had a 95% blockage in his left anterior descending coronary artery, and a stent was inserted. He showed steady improvement and was able to ambulate short distances without difficulty. He was transferred to the cardiac step-down unit. He has advance directives on file and is to be resuscitated in the event of a cardiac arrest. His wife and daughter are visiting.
Mr. Walsh’s monitor begins to alarm as you enter the room. His daughter says, “He says he can’t breathe.” You (the respiratory therapist) quickly assess the abnormal cardiac rhythm on the monitor (ventricular tachycardia) and call the rapid response team. His wife and daughter are confused by the sequence of events and anxious. As you begin to assess him, he goes into cardiac and respiratory arrest. After finding no carotid pulse, you begin cardiopulmonary resuscitation just as the rapid response team arrives.
Discussion Questions
- What information needs to be communicated to Mr. Walsh’s wife and daughter, by whom, and in what form?
- Should Mr. Walsh’s wife and daughter be given the choice to stay in the room?
- Explain your choice. How will you communicate this (your choice) to them?
- Anticipate the feedback that you might get from Mr. Walsh’s wife and daughter after your communication. Propose how you will respond to that.
- What (and how) will you communicate to the rapid response team?
Case Study: Communication in an Emergency
Mr. Walsh is a 68-year-old man who was admitted to the cardiac care unit (CCU) 2 days ago after a myocardial infarction (MI; “heart attack”). It was determined that he had a 95% blockage in his left anterior descending coronary artery, and a stent was inserted. He showed steady improvement and was able to ambulate short distances without difficulty. He was transferred to the cardiac step-down unit. He has advance directives on file and is to be resuscitated in the event of a cardiac arrest. His wife and daughter are visiting.
Mr. Walsh’s monitor begins to alarm as you enter the room. His daughter says, “He says he can’t breathe.” You (the respiratory therapist) quickly assess the abnormal cardiac rhythm on the monitor (ventricular tachycardia) and call the rapid response team. His wife and daughter are confused by the sequence of events and anxious. As you begin to assess him, he goes into cardiac and respiratory arrest. After finding no carotid pulse, you begin cardiopulmonary resuscitation just as the rapid response team arrives.
Discussion Questions
- What information needs to be communicated to Mr. Walsh’s wife and daughter, by whom, and in what form?
- Should Mr. Walsh’s wife and daughter be given the choice to stay in the room?
- Explain your choice. How will you communicate this (your choice) to them?
- Anticipate the feedback that you might get from Mr. Walsh’s wife and daughter after your communication. Propose how you will respond to that.
- What (and how) will you communicate to the rapid response team?