COPD: What Happens When You Call an Ambulance?

[Thomas3.20.2010]

At the top of my list of what I choose not to happen under any circumstances is to be intubated. It's my worst nightmare! There is a document in Colorado that you can complete with your General Practioner called a MOST, (Medical Orders for Scope of Treament) a type of Living Will that you keep handy for the EMTs who come to attend you. You can call the shots even when you can't respond by having this document accessible.

I would have the tendency to not call the ambulance for fear of what they might do to me! Do I want CPR? Do I want DNR (do not resuscitate)? Do I want Full Code? (do whatever it takes to keep me alive)? With a Living Will you decide! But only if the EMTs have access to the document at the time of treatment! In absence of directives they will Full Code.

Here is a description of what ambulance Technicians do when they transport you to the hospital:

COPD exacerbation: 5 things EMS providers need to know 

This is very good for COPD patients, their Medical Power of Attorney and their Loved Ones to know!

Once you get to the hospital, you can have a MOST or Living Will registered there so the Staff already knows your directives even before you get there!

These are hard subjects to think and talk about, but very important! I don't want to wake up with a tube shoved down my throat! But that's ME! I and my Family are prepared to honor my Directives.

Are you prepared?

[JRC]

My DH and I keep a DNR signed statement here at the house for him, although the medical reason is different. It is a good thing to consider for other than the diagnosis of COPD. Good blog to cause thinking and planning.

[elvan]

I don't want to be intubated either unless the expectation is that it will be very short term.  It can simply give your body a rest and allow it to heal.  Not everyone who is intubated ends up dying, I have seen many patients get better and be very grateful that they were given that chance.

[YoungAtHeart]

The intubation wasn't so much the problem for me - the amount of drugs to keep you under for it was MY problem.  I was dreaming that I was floating on a bed of bubbles in space, and I kept dreaming I was yelling for help and no one responded.  In my drugged state, I kept trying to say it more slowly, more clearly, louder - trying to get someone's attention.  It was a nightmare that wouldn't end.  When they lessened the dose, I pulled the d@mn thing out myself!  I was in ICU at the time - and it was a PTSD inducing time for me. My surgery was on an emergency basis - so I ended up in a non-top-notch hospital with the surgeon on call.  As I understand it, my sat levels were low, and the surgeon and ICU doctors disagreed about the intubation - the ICU doctor said low saturation levels were normal after this kind of surgery, but the surgeon INSISTED on the intubation.  I will never forgive him for that (or the six month pregnant incisional hernia he created!).

[Silverstar]

Rough topic, Thomas, tough decisions to have to make, but good to let people know that having a directive available to emergency responders is required to be sure your wishes are honored. 

[Barbara145]

The ER that I was taken to in August for respiratory failure put me on a Bi-Pap instead of entubation. It was wonderful.  It breathed for me with no pain or discomfort. I wouldn't want to have a lung transplant either. Like you said Thomas, I am doing my part and the rest is in God's gentle loving hands.

[elvan]

I do not want to be intubated, however, if there is an expectation of a positive outcome and the intubation is expected to be short term to give me a chance to rest,  I am okay with that.  No lung transplant and no on and on and on heroic measures.  I have never signed anything but you have reminded me Thomas3.20.2010  and I need to do that.  I remember, as a nurse, being on the receiving end and hearing that a patient would NEVER have wanted to be intubated after it is already done is a tough one.  

[PirateQueen]

i wear a red usb bracelet marked 9-1-1, which i keep updated with pdf versions of my MOST, Living Will, Advance Care Directives, Power of Attorney and Emergency Contact Info, medications n allergy list, and medical history, as well as primary care, specialists and pharmacy, even Religious Preference n Burial Info- not to be morbid, but my state has awful indigent corpse policies, that are against my faith, and just in case, better safe than sorry. An EMT can plug the usb end right into the ambulance laptop n read the pdfs after scanning them, as can ER personnel on their computers. The last couple 911 incidents, it has been a lifesaver.

the med alert version sells for $30 and up, but you can get a simple red or orange usb bracelet for $5 to $10 and write 911 or ICE- in case of emergency- on it. Simply convert your files to .pdf and copy to the usb drive into appropriate folders clearly labelled. please make sure each file is named clearly and completely, so it is easy for emergency folks to find easily.

[TerrieQuit]

Sounds like I need to revise my living will asap! Thanks, Thomas! Great responses/comments, too!  ~Terrie~