tag:blogger.com,1999:blog-7423880838207203660.post6542639907653090352..comments2024-01-10T09:56:49.324-05:00Comments on Respiratory Therapy Cave: BiPAP on DNR patients: an ethical issueRick Freahttp://www.blogger.com/profile/01132949384071592216noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-7423880838207203660.post-1844475227349145672013-04-12T12:26:08.633-04:002013-04-12T12:26:08.633-04:00As a student, I haven't strongly developed my ...As a student, I haven't strongly developed my stance on DNR/AND patients. But I do believe that BIPAP can be used on them...it is non-invasive and while some feel that it is uncomfortable, some changes and adjustments in settings, mask etc can probably fix that right? Also, patients who are DNR and have a history of COPD have probably been on BIPAP many times before, (since high CO2 is an indication for using it) so discomfort may not be as big of an issue as some may think. (people get used to things over time). I am a firm believer in doing what the patient wants! I think that since this is an ethical issue, that NIPPV measures should be added to the list of questions when patients are asked about advanced directives. If the pt is conscious and able to speak for him or herself at the time, then that patient can specifically state whether or not NIPPV is ok. If not, then of course that is another issue! lol. I think that while healthcare members have the control of making that decision, every effort should be made to speak to the patient's next of kin, family members, etc. to at least get an idea of what that patient may have wanted for him or herself if the patient is unable to speak or has not provided written documentation indicating NIPPV measures are ok. It must be a difficult decision though because ultimately even though we have that control we need to remove our biases, beliefs, etc in order to truly do what is right for each patient!Anonymoushttps://www.blogger.com/profile/13689187283816411941noreply@blogger.com