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Aging and the ICU: Podcast with Lauren Ferrante and Julien Cobert

GeriPal

This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today. I’m going to turn to you Lauren.

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Surrogate Decision Making: Bernie Lo and Laurie Dornbrand

GeriPal

And now ICU care has flourished, and we can keep people alive in the sense that their heart is beating and we can sustain their ventilation and circulation. For example, I had another patient in the ICU who she was on a ventilator. They didn’t come up in geriatrics very much. And we see that too in geriatrics.

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PC Trials at State of Science: Tom LeBlanc, Kate Courtright, & Corita Grudzen

GeriPal

And that helped them focus on that instead of, say, the blood pressure, the vasopressors or the ventilator settings that day. And then they had to be receiving 48 hours of continuous mechanical ventilation at a minimum and be an adult. Eric: And how did you do that? There were nine disease categories. Eric: Okay.

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What can we learn from simulations? Amber Barnato

GeriPal

I’d be willing to take some time on a mechanical ventilation machine to live longer.” And so the idea that patients are walking around with these on their shoulder like, “Hey, I got the mechanical ventilation preference, just want to make sure.” ” Because I’m like, “Yeah, to what end?

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Advance Care Planning Discussion: Susan Hickman, Sean Morrison, Rebecca Sudore, and Bob Arnold

GeriPal

Alex: Also returning Rebecca Sudore, who is professor of medicine at the UCSF in the division of geriatrics, and is a geriatric and palliative care doctor. I don’t need a checkbox form, I don’t need to know about CPR or mechanical ventilation. Welcome back, Rebecca. Rebecca: Thanks for having us. Who are they?

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The Language of Serious Illness: A Podcast with Sunita Puri, Bob Arnold, and Jacqueline Kruser

GeriPal

I think one of the residents you asked how would they broach a subject, and he said wording like, “Unfortunately, he still needs a ventilator.” ” You talk about this too, even in your own training, where even around CPR, the training is like he might need a ventilator if he couldn’t protect his airway.

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POLST Evidence and Update: Kelly Vranas, Abby Dotson, Karl Steinberg, and Scott Halpern

GeriPal

I can on one hand count the patients I’ve cared for who didn’t want mechanical ventilation. I can correspondingly count on one hand the number of patients I’ve cared for who said I want to be on mechanical ventilation at all costs, even if it means I will never come off.

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