[Expert Solution]: Q34

Q34. Jose, a 51-year-old man who now suffers from COPD due to long-term smoking, was admitted to the ER because of respiratory distress. Six months ago, while being admitted due to the same reasons, he executed an advance directive of not wanting any respiratory support. A copy of his advance directive was made available to the unit, however, he firmly states that he wants everything done to save his life. During his stay in the facility, he suddenly codes. What is the TOP priority of the ER staff? Review and honor the advance directive. Have a discussion with the team regarding the patient’s verbalized wish to be saved or to honor the advance directive. Perform basic and advanced life support to revive the patient such as CPR, defibrillation, medication, and so on; communicate to the team his informed decision against his advance directives before coding and expressing his choice while conscious and competent. Remind the team that advance directives always trump last-minute verbal wishes.