Archives

Staying in the Room

Volume 16, Issue 7, December 2015.
Jesse Z. Kellar, MD, et al.

The call from the nursing home relayed that an 85-yearold
male was coming in by ambulance complaining of
increased shortness of breath. The nursing home told us that
he had an unknown code status. Once the patient arrived, it
was clear that he was in the process of dying. While I was
preparing for aggressive resuscitative efforts, my attending
physician was shuffling through some paperwork that came
with the patient and discovered a “do not resuscitate” order,
signed by the patient. The paperwork also stated that he had
advanced cancer. It was clear why the patient had previously
decided he did not want any procedures to be done, which
we were quickly prepping to perform. With this added
information we put a stop to our efforts, followed the wishes
of the patient, and made him as comfortable as possible in his
final moments.

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Emergency Medicine is a specialty which closely reflects societal challenges and consequences of public policy decisions. The emergency department specifically deals with social injustice, health and economic disparities, violence, substance abuse, and disaster preparedness and response. This journal focuses on how emergency care affects the health of the community and population, and conversely, how these societal challenges affect the composition of the patient population who seek care in the emergency department. The development of better systems to provide emergency care, including technology solutions, is critical to enhancing population health.