44 Family Updates In The ICU

44.1 What this covers

Code status when things are going badley
introduce yourself and the team members.
clarify when you will be available, or what other team members are available and for how long

44.2 Learning objectives

Code status when things are going badley
introduce yourself and the team members.
clarify when you will be available, or what other team members are available and for how long
start by asking what they’ve been told with a flag that you’re interested so you can start at the right place, not as a ‘quiz’ (phrasing it like this can help to avoid the dynamic where they feel like their healthcare literacy is under question and something to be embarrassed about)
when you give updates, reference specific tests/results
“What do you think the patient would have wanted” as a frame. Off loads feeling of responsibility
learning about the patients and values and preferences - what did they really like to do?

44.3 Bottom line / summary

##First conversation:
##Are they going to be ok?
Almost no one is ever, with certainty, going to be fine who is in the ICU.
Your goal should be to have them understand what is wrong with the patient and reassure them that their family will be well cared for.
introduce yourself and the team members.

44.4 Approach

introduce yourself and the team members.
clarify when you will be available, or what other team members are available and for how long
start by asking what they’ve been told with a flag that you’re interested so you can start at the right place, not as a ‘quiz’ (phrasing it like this can help to avoid the dynamic where they feel like their healthcare literacy is under question and something to be embarrassed about)
when you give updates, reference specific tests/results
“What do you think the patient would have wanted” as a frame. Off loads feeling of responsibility

44.5 Red flags / when to escalate

TODO: List red flags that require urgent escalation.

44.6 Common pitfalls

start by asking what they’ve been told with a flag that you’re interested so you can start at the right place, not as a ‘quiz’ (phrasing it like this can help to avoid the dynamic where they feel like their healthcare literacy is under question and something to be embarrassed about)

44.7 References

TODO: Add landmark references or guideline citations.

44.8 Source notes

44.8.1 Family Updates In The ICU

45 Family Updates in the ICU

45.1 First conversation:

introduce yourself and the team members.
clarify when you will be available, or what other team members are available and for how long
start by asking what they’ve been told with a flag that you’re interested so you can start at the right place, not as a ‘quiz’ (phrasing it like this can help to avoid the dynamic where they feel like their healthcare literacy is under question and something to be embarrassed about)
when you give updates, reference specific tests/results

45.2 Are they going to be ok?

Almost no one is ever, with certainty, going to be fine who is in the ICU. Your goal should be to have them understand what is wrong with the patient and reassure them that their family will be well cared for. However,

45.3 Code status:

“What do you think the patient would have wanted” as a frame. Off loads feeling of responsibility
learning about the patients and values and preferences - what did they really like to do?
offer a recommendation, with a signal that you’re curious if they agree.
would they want input from someone else?

45.3.1 Code status when things are going badley

NEVER just straight up ask “do you want us to do chest compressions and put a tube down your throat?”
NEJM article framework.

Documentation:

if decisions- identify if patient can participate, or if not, why not
document what the purpose of the discussion was
document information shared, concerns, and

45.4 Source materials

Clinical Practice Notes/family-updates-in-the-icu.md