ultimately do what you think he/she would want. there is no right or wrong answer, but to be honest, there are a lot of tools in medicine to keep someone alive. however, it is not pain free and is taxing on both the patient and their families.
that being said, the road to recovery from whatever brought her to the hospital will be a long one.
if there are permanent deficits or if they are likely to be bedbound, is that a life they would want to live? because in the scenario they make it out, they are the ones who will have to live with it.
furthermore, especially with younger people, the road to recovery may require extensive rehab and can take up to years. it is important if he/she were to live through this that they have the proper family support system. otherwise it will be all for nothing, and they will end up in the icu again due to medical complications from chronic medical conditions and you may face a similar situation again.
DNR means they won't attempt to resuscitate her if her heart stops beating via CPR and defibrillation.
DNI means they won't attempt to intubate her and put her on a ventilator if she stops breathing.
It doesn't really make sense to pick DNR or DNI only except for rare situations. Typically people who need CPR and shocks also need to be intubated. DNR only or DNI only has a poor prognosis built into it, and if you want the best outcomes, it doesn't make sense to only half ass it.
If you pick DNR/DNI, it does not mean the doctors are not trying to do all that is best for the patient. If they need fluid, antibiotics, etc, they will get everything. The overall management doesn't really change. The only real exception is for people with terminal illness and poor prognosis, they will prioritize treating pain or difficulty breathing when all other measures fail, even though the treatment for pain may indirectly put them at risk for respiratory failure and subsequent death and they know they cannot intubate. Some times people are in a checkmate position in respiratory distress despite antibiotics and steroids and the only option left is to make them comfortable. Doctors won't give pain meds as a priority to hasten someone's death if there is an alternative solution to try first.
DNR/DNI is an option that is offered basically to prevent someone from undergoing traumatic treatment that would likely yield a poor result. CPR breaks ribs, and for instance, if you came into the hospital with respiratory failure and a known chronic lung condition, good luck trying to get off of the ventilator with bad lungs AND recovering from broken ribs at the same time.
that being said, the road to recovery from whatever brought her to the hospital will be a long one.
if there are permanent deficits or if they are likely to be bedbound, is that a life they would want to live? because in the scenario they make it out, they are the ones who will have to live with it.
furthermore, especially with younger people, the road to recovery may require extensive rehab and can take up to years. it is important if he/she were to live through this that they have the proper family support system. otherwise it will be all for nothing, and they will end up in the icu again due to medical complications from chronic medical conditions and you may face a similar situation again.
DNR means they won't attempt to resuscitate her if her heart stops beating via CPR and defibrillation.
DNI means they won't attempt to intubate her and put her on a ventilator if she stops breathing.
It doesn't really make sense to pick DNR or DNI only except for rare situations. Typically people who need CPR and shocks also need to be intubated. DNR only or DNI only has a poor prognosis built into it, and if you want the best outcomes, it doesn't make sense to only half ass it.
If you pick DNR/DNI, it does not mean the doctors are not trying to do all that is best for the patient. If they need fluid, antibiotics, etc, they will get everything. The overall management doesn't really change. The only real exception is for people with terminal illness and poor prognosis, they will prioritize treating pain or difficulty breathing when all other measures fail, even though the treatment for pain may indirectly put them at risk for respiratory failure and subsequent death and they know they cannot intubate. Some times people are in a checkmate position in respiratory distress despite antibiotics and steroids and the only option left is to make them comfortable. Doctors won't give pain meds as a priority to hasten someone's death if there is an alternative solution to try first.
DNR/DNI is an option that is offered basically to prevent someone from undergoing traumatic treatment that would likely yield a poor result. CPR breaks ribs, and for instance, if you came into the hospital with respiratory failure and a known chronic lung condition, good luck trying to get off of the ventilator with bad lungs AND recovering from broken ribs at the same time.