Comments on: performing emergency care without the clients consent

01 May 2020

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The dilemma

Daisy, a seven-year-old German shepherd dog presents as inappetent and severely lethargic, dyspnoeic, has muffled heart sounds and a distended abdomen. You suspect pericardial effusion and obtain verbal permission from the owner to place her on supplementary oxygen. Daisy quickly arrests and the owner has not yet agreed to emergency stabilisation. You must decide immediately whether to perform pericardiocentesis and initiate cardiopulmonary resuscitation. What do you do? (IP, April 2020, vol 42, pp 181-182)

The initial concern should be resuscitation, and whether invasive procedures, in this case pericardiocentesis, should be performed on the patient before the owner has given their consent. First and foremost, delaying such a procedure would result in an increase of the arrest time before the initiation of cardiopulmonary resuscitation (CPR), which subsequently would make the outcome of cardiopulmonary arrest worse. CPR must be performed as soon as possible to improve the...