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Related Concept Videos

Cardiopulmonary Resuscitation II: ACLS Airway Management01:22

Cardiopulmonary Resuscitation II: ACLS Airway Management

Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned under...

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Related Experiment Video

Updated: Jul 8, 2026

A Cost-effective and Reliable Method to Predict Mechanical Stress in Single-use and Standard Pumps
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"Do we have to replace the balloon pump when it fails?"

Trevor M Bibler, Jamie M Crist, Janet Malek

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    |February 19, 2020
    PubMed
    Summary

    This case highlights the ethical dilemma of determining decision-making capacity in patients with advanced heart failure. It questions the obligation to continue mechanical circulatory support when a patient may lack capacity.

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    Area of Science:

    • Cardiology
    • Medical Ethics
    • Critical Care Medicine

    Background:

    • Patient presented with coronary artery disease and ischemic cardiomyopathy, requiring advanced heart failure support.
    • Initial acceptance for left ventricular assist device (LVAD) was pending cognitive assessment.

    Observation:

    • Patient developed cardiogenic shock, necessitating intra-aortic balloon pump (IABP) placement.
    • IABP dependency and deconditioning occurred within two weeks.
    • Attending physician and medical review board determined lack of decision-making capacity, declining LVAD candidacy.

    Findings:

    • Heart failure and CICU teams recommended terminal weaning of IABP and comfort care.
    • Family disagreed, citing patient's continued engagement and eating.
    • Ethical impasse reached regarding continued mechanical support.

    Implications:

    • This case underscores the complexities in assessing patient capacity for medical decisions in critical care settings.
    • It raises questions about the ethical obligations of healthcare providers when faced with conflicting views between medical teams and families.
    • The scenario prompts a discussion on the balance between aggressive treatment and patient-centered comfort care in advanced heart failure.