Performing emergency care without client consent

01 Apr 2020

Evans, E.

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The dilemma

A seven-year-old German shepherd dog, Daisy, is presented to the clinic. She is inappetent and severely lethargic. Furthermore, on examination you find that she is dyspnoeic, has muffled heart sounds and a distended abdomen. You suspect pericardial effusion and obtain verbal permission from the owner to place Daisy on supplementary oxygen. Daisy arrests as soon as you take her through to the preparation area and, although your colleague has begun discussing resuscitation options, the owner has not yet agreed to emergency stabilisation in the event of a cardiopulmonary arrest. You must decide immediately whether to perform pericardiocentesis and initiate cardiopulmonary resuscitation without the client’s consent. What do you do?

Issues to consider

The stakeholders include Daisy, her owner and the veterinary team. Due to the impact your decision will have, how you proceed must be carefully considered, especially since the wishes of the owner...