It’s the nature of emergency medicine, said Christopher Colwell, MD, FACEP, interim director of the department of emergency medicine and staff physician at Denver Health Medical Center and associate professor at the University of Colorado School of Medicine in Aurora, that no shift is complete without a patient who is “combative, uncooperative, unhappy, or mentally altered for other reasons.”
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“We are left sorting out, does this patient have the capacity to make decisions for themselves, or do I need to hold them against their will and make decisions for them?” —Dr. Colwell
“We are left sorting out, does this patient have the capacity to make decisions for themselves, or do I need to hold them against their will and make decisions for them?”
In his Wednesday session, “The Combative, Uncooperative Trauma Patient,” Dr. Colwell will take a case-based approach to provide practical strategies in caring for even the most challenging patient while also considering the legal and ethical implications. Free will is important, he said, but so is the safety of the patient and others.
Deciding to restrain or sedate a patient can be one of the most difficult choices emergency physicians make, Dr. Colwell said. “It’s a high-risk situation with high stakes.” But emergency physicians are accustomed to making definitive decisions based on inadequate data. “It’s what our profession is based on.”
No matter the trauma setting, from inner-city hospital to small rural health center, his session will provide emergency physicians the basics for becoming comfortable making these kinds of decisions. And, he said, it promises to be lively.
Kelly Tyrrell is a health, science, and health policy writer based in Madison, Wisconsin.
The Combative, Uncooperative Trauma Patient
Wednesday, Oct. 28
Room 205 ABC