The suggestion NHS intensive care units thoughtlessly turned away COVID patients purely because of their age is very upsetting. This article quotes ICU doctors off the record but I don't recognise these experiences. We cared for a number of patients aged 80+ on @teamaccu 1/7 https://twitter.com/thesundaytimes/status/1320274025105494016
A 'triage tool' was developed by @NICEComms but doctors decided not to use it. Instead we fell back on a long standing practice of discussion between experienced NHS consultants (at least three). Patient and family views were always included if possible. 2/7
Being on a ventilator in intensive care is not nice. You wouldn't do it to anyone you loved unless you thought it could help them. But few people outside ICU (doctors or public) realise this and often argue strongly to ventilate patients who have little chance of survival. 3/7
When this happens we usually admit the patient even though we dont expect them to survive. It's hard to refuse. But for a few weeks in the first wave it seemed the whole country understood. We admitted anyone with a realistic chance. People accepted these difficult decisions. 4/7
I work in one of the NHS trusts worst hit by COVID. We never used fixed rules about who could or couldn't be admitted to ICU. I know many docs working in hospitals large and small who say the same. Ethical concerns raised in this article reflect the concerns of doctors too. 5/7
In March, we were terrified the first wave would keep rising until we were forced to impose blanket rules. Senior docs were dreading it. To our massive relief, patient numbers stabilised just in time. We got away with it. If there were exceptions, I never heard about them. 6/7
I sort of always understood that society's memory of the first wave would dim over time. It was a desperate time that threatened everything ICU staff stand for in patient care. This is why I recorded my own history in an audio diary for @BBCRadio4: https://twitter.com/RoyalLondonHosp/status/1260253660539478018?s=20 7/7
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