What Would You Do? Ethics in Emergency Medicine
By Bernard Heilicser, DO, MS, FACEP, FACOEP-D

I would like to present a situation which occurred in a nursing home that created an interesting ethical dilemma. A nursing home called 911 for an unconscious resident. On arrival, EMS found the patient pulseless and apneic, with staff performing CPR. The downtime was about eight minutes. The crew hooked up the patient, and he was in asystole. At that moment, a nurse’s aid arrived with a Do Not Resuscitate order on the chart, and appropriately, executed. One of the responding EMS individuals noticed the patient was lying next to a feeding chair with a diced hot dog on the tray. A paramedic was gathering equipment for intubation and was instructed to insert his laryngoscope. Exclaiming a profanity, he observed a piece of hot dog in the airway and removed it with a McGill’s forceps. CPR continued for a few more moments, and the patient regained a pulse and spontaneous respirations.

Did the crew do the right thing to resuscitate the patient in this situation?