Family Presence during Cardiac Resuscitation

Abstract

Roberta is a 72-year-old woman with hypertension and chronic obstructive pulmonary disease who has smoked for the past 50 years. She is admitted to the inpatient medical service after 3 days of progressively worsening fever, chills, and productive cough. On presentation to the emergency department, her temperature is 38.4°C (101.2°F), her heart rate is 110 beats per minute, and her blood pressure is 105/62 mm Hg. The respiratory rate is 26 breaths per minute, and the oxygen saturation while she is breathing ambient air is 86%. Chest radiography reveals an infiltrate at the right lung base consistent with pneumonia. She receives ceftriaxone and azithromycin, an intravenous saline solution, and supplemental oxygen through a nasal cannula. By the time she arrives at the inpatient unit, her heart rate has slowed to 86 beats per minute, the respiratory rate is 20 breaths per minute, and the oxygen saturation is 96% while she is breathing 4 liters of supplemental oxygen. As her attending physician, you confirm with the patient that she wants to receive aggressive medical therapies, including cardiopulmonary resuscitation, if her medical condition deteriorates.