I work in a MOLST state…. Apparently some of y’all are “POLST” - who knew? Also what is a POLST? Obviously it’s y’all’s MOLST but why are we different? Is one better than the other??? This comes up after a hypothetical arose. In an unrelated circumstance in a place far far away a person somewhere was eating lunch in a hospital bed. They are med ready for discharge. Have a progressive disease but are not at end stages at all…. Suddenly they choked on a very large piece of over cooked chicken covered in so much gravy the yank never stood a chance of clearing that airway…. Since their illness has potential related complications the patient made it clear. That they wouldn’t want extreme life sustaining measures if another stroke were to happen…. At least that’s what is assumed because after stroke their code status changed from A1 to A2…. This is a clear acknowledgment that they wouldn’t want to use extreme measures to prolong the course of a progressive disease. But does it mean that when a truly reversible situation arises they wouldn’t feel differently about CPR?? That overcook meat has so perfectly obstructed that airway- it took less that a minute for LOC…. And then cardiac arrest…. Obviously the legally correct answer is AGGRESSIVELY respect MOLST…. Legally you should only “provide support” You must trust that while he had SLP eval which cleared him to safely eat regular diet (not we would rec X but they refuse) - he truly thought about if he accidentally choked on lunch, LOC in under a minute level airway obstruction, we would not treat that reversible condition that happened to involve brief cardiac arrest? I’m not trying to make light of anything…. There was a conversation had and in this situation we came up with we wonder about how detailed consent to refuse treatment is in a similar circumstance….   submitted by   /u/Username_Pickles [link]   [comments]