What Are Examples of Quick Decision-Making With Positive Patient Outcomes?
Doctors Magazine
What Are Examples of Quick Decision-Making With Positive Patient Outcomes?
To highlight the importance of quick decision-making in patient care, we asked medical professionals this question for their best examples. From prioritizing mental health for holistic healing to recognizing and treating neurogenic shock quickly, here are the top four instances these experts shared where swift decisions led to positive outcomes for patients.
- Prioritize Mental Health for Holistic Healing
- Act Swiftly on Suspected Ovarian Torsion
- Systematically Address Reduced Tissue Perfusion
- Recognize and Treat Neurogenic Shock Quickly
Prioritize Mental Health for Holistic Healing
As a physician assistant, I pride myself on treating the patient holistically, and that requires weighing mental health as a co-morbidity, even if there are no specific pre-existing diagnoses. Physical improvements are intrinsically linked to a patient's emotional state, and depressed or anxious people struggle to get better.
Recently, I had a patient whose wound care had been exhausting. Every time we got it under control, another spot would open up, and the patient was starting to lose hope.
That morning they were scheduled for another debridement, but I could see that they were faltering. While putting it off was risky, I was gravely concerned about their mental well-being and decided to prioritize a psychologist visit instead. It was something I had to decide at the last minute, and I worried about my choice the rest of the day.
But, when I came back the following week, they'd taken a turn for the better, not just mentally, but physically as well. The psychologist had developed a care protocol that included the family, and suddenly, support for the patient had blossomed. They were eating better and bathing more often. It was a great validation for me and solidified my belief in holistic care.
Act Swiftly on Suspected Ovarian Torsion
As a naturopathic doctor specializing in infertility, there was a memorable instance where I had to make a quick decision that resulted in a positive outcome for a patient.
A patient came to me with unexplained infertility and a history of irregular menstrual cycles. During our consultation, she mentioned she was experiencing sudden, severe pelvic pain, which she had initially dismissed as menstrual cramps. Given her symptoms and medical history, I immediately suspected a possible ovarian torsion, a condition that can compromise ovarian function and impact fertility if not treated promptly.
I quickly referred her to the emergency department for an urgent ultrasound. My swift decision led to the detection of ovarian torsion. She underwent surgery that same day, and her ovary was saved.
Post-surgery, we resumed our work on optimizing her fertility through a tailored naturopathic plan, including functional lab testing, nutrient supplementation, botanical medicine, and lifestyle modifications. Within three months, she conceived naturally and later delivered a healthy baby.
This experience reinforced the importance of listening carefully to patient symptoms and acting swiftly when necessary, combining naturopathic care with conventional medical interventions to achieve the best fertility outcomes.
Systematically Address Reduced Tissue Perfusion
During a recent cosmetic procedure, I observed reduced tissue perfusion that could impact the final result. I first checked the patient’s blood pressure to ensure it was within normal limits. Next, I evaluated the use of epinephrine, verifying it was administered at the correct dose. To further address the issue, I applied a topical vasodilator, adjusted the patient’s positioning, and released some sutures to relieve tension. Allowing time for tissue recovery led to excellent reperfusion and an optimal outcome. This systematic approach ensured a successful result for the patient.
Recognize and Treat Neurogenic Shock Quickly
My father once told me you will never find a brilliant young author or doctor because these professions require too much life experience, trial and tribulation, and observation before they are ready to share their talents with the world. The art of medicine is the ability to differentiate between similar-looking shades of gray and this takes training, practice, and pattern recognition. Diseases follow patterns and once a doctor has put the prerequisite 10,000 hours of practice into his training medicine becomes a high-stakes matching game of symptomology to disease and the implementation of the appropriate treatment plan.
I was working in the emergency department at a hospital near downtown Los Angeles when a man was brought in by friends and dumped in the lobby of the emergency room. He had been shot in the back as he turned to run when a rival street gang burst through the door of a neighborhood party and began shooting. No obvious deficits were immediately apparent but, as he was brought back to the trauma bay I noticed his blood pressure and pulse were simultaneously dropping.
A short time later he wasn’t moving his legs. This is a textbook case of neurogenic shock. It results from a spinal cord injury that disrupts the autonomic nervous system that controls the internal organs. Without timely intervention, it is universally fatal. This pattern of low blood pressure and heart rate is easy to recognize but never seen under normal conditions as low blood pressure is accompanied by a high pulse because the heart picks up to maintain normal profusion. In neurogenic shock, however, spinal damage disrupts this feedback loop causing both blood pressure and pulse to drop together. It is rare in a community setting, and although I had studied it many times, had never seen a case.
My timely recognition of his condition allowed for the quick addition of Norepinephrine which is a catecholamine that increases blood pressure and maintains profusion to the vital organs. Without this simple but critical intervention, he likely wouldn’t have survived transport to a trauma center. When a true emergency presents to the ER we must stay focused, turn down the noise, and rely on our professional mantra, ABCDE, which stands for airway, breathing, circulation, disability, and exposure.
I followed the algorithm to a T and it saved his life. As it is said in Jiu Jitsu; In the beginner's mind there are many options, in the master's mind there are very few.
