Your Stay at GVH
Life-Saving Options
What Treatment Would you Want if Your Heart or Breathing Stopped?
When you are a patient at Grand View Hospital, we support your right to make decisions regarding your care. This includes choices about what would be done to save your life if your heart or breathing stopped. Sometimes, efforts to save a life might be unpleasant for the patient or change the quality of life. As a result, some patients decide they would not want all of the life-saving options available. This brochure talks about your options for life-saving medical treatment.
Emergency Response
If your breathing or heart stops while you are in the hospital, a team of nurses and other hospital workers will come to you
immediately. They will help start your breathing and circulation. The steps they may use include:
- Compressing your chest (CPR)
- Providing electrical shock (defibrillation)
- Placing a breathing tube in your nose or mouth (intubation)
- Connecting you to a breathing machine (ventilator)
- Inserting a pacemaker in your chest
- Giving you special medications
Making Decisions about Your Care
Before an emergency happens, talk with your doctor about each of these. Then decide which of these choices you would want.
Unless you select one or more of the choices above, all emergency steps will be taken.
A plan to tell our staff what to do if your heart or breathing stopped (emergency response plan) is different from a living will. You need to talk to your doctor about your emergency response plan.Your choices will not affect the quality of care you would receive. In addition, you may change your choices at any time. Just tell your nurse or doctor that you have changed your mind.
Levels of Emergency Treatment
Full Code (Level 1)
This tells hospital workers to use any and all ways to start your breathing and heart pumping. If you are not breathing, hospital staff will place a breathing tube in your windpipe. The tube will be attached to a breathing machine. The emergency response team will give you CPR (chest compressions) in an attempt to start your heart beating. If needed, they will place paddles on your chest and give you electrical shock to help your heart beat normally. They will give you special medications and use any other means to help you to breathe and your heart to beat.
Health-care professionals responding to a lifesaving emergency is called a code. Its purpose is to help you regain your ability to breathe and your heart to pump blood. A code will not correct existing problems or chronic illnesses. The code may cause pain due to broken ribs or a punctured lung or liver. In addition, you may need a breathing machine for the remainder of your life.
Full Code without Long-Term Ventilation (Level 2)
With this option, you would not be placed on a breathing machine (ventilator) in an emergency, but would receive all of the other lifesaving measures talked about above.Your doctor will assess your condition and your chances of recovery. Then, taking your wishes into account, your physician will decide which treatment you would receive.
This might include CPR (chest compressions), electrical shock, a breathing tube, medications and a pacemaker. Please understand that by refusing a breathing machine (ventilator), you are taking a chance that you might die without it.
Do Not Resuscitate (DNR) with Medical Treatment (Level 3)
This allows you to have medication and treatment changes as needed if your heart or breathing stops, but no other measures. You would not receive a breathing machine, CPR (chest compressions), breathing tube or electrical shock. The hospital staff will tell your doctor if your condition changes so that necessary treatment or medications can be ordered. For example, if your heart rhythm changes, your doctor may order medication to readjust the rhythm so that your heart beats more effectively. The staff will not give you an electrical shock (defibrillation) or CPR (chest compressions).
Do Not Resuscitate (DNR) Comfort Care (Level 4)
This indicates that no lifesaving measures will be started if your heart or breathing stops. The goal of treatment will be to make you comfortable. The staff will manage pain or other symptoms related to your illness.
The decision to begin or not to begin life support must be made carefully, especially if long-term life support is not your wish. Once begun, it can be ethically or legally difficult to discontinue life support for a patient who may or may not be able to make decisions.
We strongly encourage you to consider talking about this decision with the people who care most about you. It is important that you feel you have made the most appropriate decision. In addition to your physician, you may talk with our chaplain and social workers.
Glossary
Breathing Tube
A tube that goes through the nose, mouth or windpipe (trachea) and ends in the lungs (bronchus) to deliver air. This tube is
usually called an “endotube.” The process of placing the breathing tube into the windpipe is called “intubation.”
Cardiopulmonary Resuscitation (CPR)
An attempt to restore breathing and/or heartbeat. The “C” stands for cardio, or heart. The breast bone is pressed (chest
compressions) to help blood to flow and the heart to work. The “P” stands for pulmonary and refers to efforts to provide air filled with oxygen to the lungs after breathing stops. The “R” refers to resuscitation, which stands for restoring heartbeat and breathing.
Code
A word used to describe an organized response by hospital personnel to provide lifesaving measures for a patient who is
experiencing extreme problems with heartbeat or breathing.
Defibrillation (Electric Shock)
A machine with flat paddles that delivers an electrical shock through the chest wall to change the electrical pattern of the heart into a normal one.
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