Zara Cooper
speaker
200 appearances
1 recordings
1 series
first heard Sep 2017
last heard Sep 2017
Zara Cooper’s voice in public audio — every appearance, attributed to the second.
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Appearances
Well, I will say that, you know, in our centre we uh have had
Um, a lot of success uh recently because about three years ago we went to a triggered consultation model and our service now um has a fifty percent FTE geriatrician who routinely rounds on our geriatric trauma patients.
And so I I will say that actually our rates of MOLST completion.
um are actually higher than on the oncology service.
Molds
Yes, exactly.
And so I'm very proud of that.
And you know, we've we've also noticed that we've had um increases in DNR, DNI orders.
And you know, that that in and of itself um isn't so noteworthy as it is that the conversations are being happened are happening and are being documented because we've implemented geriatric
kind of processes of care and palliative processes of care around these patients.
That being said, there are still cases where there are folks who will flip slip through the cracks.
And I think, you know, at other trauma centers that don't have these processes in place, it's not unusual to have an older patient who comes in, you know, they've fallen, they have um, you know, a devastating cervical spine fracture.
Let's say it's a lower cervical spine fracture, they have cervical, um, they have uh spinal cord injury.
Um and they're expected to be, you know, paraplegic, quadriplegic.
Certainly if they have cervical cord injury, it would be quadriplegic.
Um, you know, and and there's just this assumption that now they're on this treadmill and that they're going to get, you know, the most aggressive life prolonging care that they can without, you know, an evaluation of their goals and values up front, um, identifying healthcare proxies, try to figure out if advanced directives even exist.
um discussing code status and certainly for you know surgery, many of those patients may have unstable fractures that um you know might be amenable to surgery, but recognizing that that's a palliative procedure and then talking about what their trajectory looks like.
I mean I've certainly encountered families that I've taken care of in the ICU where they've been shocked to learn on day six or day seven, what do you mean mom isn't coming home?
Yeah.
So, you know, I think one of the major challenges for surgery in general, for trauma and emergency surgery in particular
Showing 41–60 of 200 · page 3 of 10
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