Transcripts
DR. CORNEL:
At the time when this was
happening a lot of decision making had to go on.
One always hopes that the decisions will be
informed and based on real knowledge and real
data but a lot of times it has to be intuitive
and based on inadequate data. If you're a
surgeon you get used to making those kinds of
decisions.
The problem here was acute heart
failure or acute cardiomyopathy and the first
thing we wanted to know: was it recoverable or
not?
We had nephrologists,
intensivists and cardiologists standing around and
I said, "Well, will this get better?" "Beats
me!" is the only answer I got.
But Dr. Simons, the intensivist,
thought that her brain had been well-protected by
the resuscitation, knew she was lucid and clear
before the she was intubated and so we felt that
was something good to work with.
We needed to know what the end
point of whatever efforts we were coming up with would
be and really, in a situation like this, it was
recovery or no recovery.
And then if you are looking at
the kinds of efforts we were contemplating we
must ask 'what can the team actually do?' There
is no point in embarking on something if you
have no capability to do it.
Our hospital is a relatively
small Children's Hospital and we're not set up
to do routine long-term life support procedures.
But we know we can do them. We do this sort
of procedure in the operating room in cardiac
surgery all the time and we had done other
procedures like this. So we knew, technically,
we could do it.
And also, when you're a small
center like ours, you have to consider the
effect of devoting all of your resources to one
patient. What effect will that have on other
patients. And it's an important consideration.
