CEN Practice Question 881-Discussion and explanation

An 8 year old victim of severe trauma is being cared for. The child is unresponsive and unstable due to suspicion of massive internal bleeding. The attending physician has initiated orders to begin a massive transfusion protocol. The parents are refusing this based on religious preferences. Which of the following should be anticipated to be done?
a) complete an incident report
b) provide the family with a do-not-resuscitate form
c) provide comfort measures only
d) initiate the massive transfusion protocol
ANSWER: d) initiate the massive transfusion protocol
If a minor presents with a life threatening emergency and standard, sound care is available, it should be given. Adults have autonomous rights, but they cannot be imposed on a minor in a life or death emergency. There are numerous examples of case law including the US Supreme Court (Prince vs Massachusetts) that held that parental rights are not absolute and even in cases of religious beliefs, the child's well-being is paramount. An incident report would possibly be completed at a later point, but it carries no implication to the care issue at hand. Do not resuscitate is a physician’s order indicating what particular life support measures would be done or withheld. This would only apply as a decision guiding form when the heart has stopped. Providing comfort measures applies to those patients who are expectant or terminal.
Mark Boswell
APRN, CEN, CFRN, CTRN, CPEN, TCRN, SCRN, NREMT-P, EMT-T
Boswell Emergency Medical Ed Tech (B.E.M.E.T.)
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