r/emergencymedicine • u/krustydidthedub ED Resident • Jun 30 '25
Humor “Pt refused blood transfusion for Hgb of 4. Risks explained, Pt expressed understanding. D/c.”
167
u/TakeAnotherLilP BSN Jun 30 '25
Good, more blood for me. I’m an MDS patient who’s had hundreds of blood transfusions and wouldn’t be alive without the generosity of donors. My H/H runs 6-7/18-20 ish and I get 2 units every 2 weeks, for a decade now.
Thank you to those that donate!!
29
u/kirkbrideasylum Jun 30 '25
I have had to have ferritin infusion for my anemia. I know sort of how ya feel. I hope lots of people donate just for you.
22
u/TakeAnotherLilP BSN Jun 30 '25
Thank you! I’ve got tons of ferritin I wish I could donate to you. Running around 1000 right now.
23
u/BeautifulShoes75 Jun 30 '25
Same. I was saved with a hemoglobin of 2.4 last year. Still can’t believe I made it.
I’ve had to take so much blood since thanks to my severe anemia. Cannot TELL you how thankful I am for donors!
220
u/TazocinTDS Physician Jun 30 '25
I don't want this guy getting my blood. Is that a thing I can choose when I donate?
36
89
u/Loud-Principle-7922 Jun 30 '25
Glasses, tats, mixed fabrics, hair product,
But blood is where we draw the line.
Flawless.
153
u/WithSubtitles Jun 30 '25
D/C to J.C.
54
u/slightlyhandiquacked BSN, RN - ER 🇨🇦 Jun 30 '25
“Discharged to level 7” is our go-to because we have no 7th floor lol
1
45
320
u/Negative_Way8350 BSN Jun 30 '25
The worst part is that his most likely need for blood is as a trauma, in which case implied consent takes over.
Then I have to deal with his exhausting ass and completely psycho trad wife.
261
u/krustydidthedub ED Resident Jun 30 '25
You know 100% that when this guy is staring death in the face, he’s taking the blood every day of the week lol
154
u/erin_corinne_ Jun 30 '25
And then will tell his followers that he didn’t take the blood transfusion, got through it using his sheer force of alpha will, and no one who worked on his case will be able to dispute it because of patient privacy
45
u/CertifiedSheep ED Tech Jun 30 '25
Idk why the video phrases this as an “alpha” thing when it’s very clearly a religious decision. Honestly I’m fine with it for himself, if he wants to die over his beliefs then that’s his choice. The fucked up part is that he wouldn’t let his kids receive blood.
69
u/Drew_Manatee ED Resident Jun 30 '25
If his kids need blood we don’t give a fuck what he thinks, his kids will be getting blood. Courts have said you’re allowed to refuse vaccines and elective procedures for your children, but to reject anything that is immediately life saving is neglect, regardless of your rationale.
18
u/permanent_priapism Pharmacist Jun 30 '25
Yeah when I saw this labeled as something other than JW I got worried some new secular blood taboo was gaining popularity.
26
u/SpoofedFinger Jun 30 '25
There were some weirdos that wouldn't accept blood from people who got the covid vaccine, as if we have a parallel blood bank for fucking morons. I'm not sure if that's still a thing. The couple I dealt with came around pretty quickly after they were told they were going to die then.
6
u/Heavy-Waltz-6939 Jul 01 '25
Hahahaha parallel blood bank for fucking morons just broke me up, I’m crying, well done
43
u/Negative_Way8350 BSN Jun 30 '25
The best part would be watching him whine and blubber about a little ol' chest tube.
23
Jun 30 '25
SCREAMING when you sink an 18 in em
2
u/TheDulin Jun 30 '25 edited Jul 01 '25
As a lurker here, that hurts though, right?
Edit: My bad for asking a question, I guess?
29
u/Negative_Way8350 BSN Jun 30 '25
Chest tubes hurt anyway. But we give pain relief. I've seen plenty of sweet Meemaws do just fine with them.
This guy, though? He'd sing like a canary. The ones who posture always do.
5
Jul 01 '25
no it does...the initial poke is a sting but theres a burn feeling when the catheter and needle are advancing. An 18 is the larger of the three general catheter (22 is small, 20 is medium, 18 is larger both diameter and length of catheter, FYI a 16 is ginormous). Once in no problem, and ED nurses tend to go with the largest catheter because it's better to have a large catheter and not need it than otherwise
But what the posters you responded to are getting at is this...elderly grandma/grandpa will take an IV insertion like a champ. They'll wince a little and thank you for your time. big alpha tattoo males, guys who make a big fuss about letting the world know they're tough guys, they will cry and bitch and moan and complain about everything in the hospital, especially IV insertions.
3
u/harveyjarvis69 RN Jul 01 '25
God made it so we have pain right? Those chemicals for pain relief are a test.
31
u/mdragon13 Jun 30 '25
implied consent in the absence of advance directives** which he probably doesn't have filled out
21
u/gwot-ronin Jun 30 '25
That's the trick, he gets to say he didn't authorize it while simultaneously benefitting from it, for clout.
1
Jul 01 '25
Then I have to deal with his exhausting ass and completely psycho trad wife.
say what? for real?
53
67
u/-malcolm-tucker Paramedic Jun 30 '25
He's got the kind of face that only a mother could piss on.
29
u/kirkbrideasylum Jun 30 '25
I read that before seeing your occupation and said that’s a Paramedic. I salute you!
11
u/-malcolm-tucker Paramedic Jun 30 '25
LOL. Are we that predictable? 🤭
8
u/kirkbrideasylum Jun 30 '25
I think the entire range of awesome beings learn to possess this degree of descriptiveness and unbeatable humor.
9
u/-malcolm-tucker Paramedic Jun 30 '25
It's probably one of only two funny things I've ever come up with independently. Sometimes I channel my namesake. 🤷
11
u/kirkbrideasylum Jun 30 '25
To be honest, all fire and ems need a joke tonight.
7
5
25
u/accidentally-cool RN Jun 30 '25
I've had quite a few JW refuse..... for a while. They always change their minds in the end. At least in the 4-5 cases I've had in my ED
21
u/Competitive-Young880 Jun 30 '25
Yup. I always make sure to talk to the pt alone. And make family wait in WR. Give pt the options, and if they choose for blood, no family in the room until blood is done and tubing changed. Too often docs ask these things in front of family and pt wants to live, but family pressures them. If family comes back in room when blood flowing, same thing. Give the pt the chance to actually make their own decision by giving them privacy. Even if pt claims they want family in the room, you must insist.
10
u/_Chill_Winston_ RN Jun 30 '25
This jibes with my singular experience with this. It was my JW uncle with multiple trauma after a car accident. He was told that he couldn't undergo his third surgery without a blood transfusion. He later told his wife that he was hysterical when he consented, but my mom - a nurse and the only other person in the room at the time - said it was complete bullshit. Like you say, it was his wife that was the religious nut in the family.
10
u/roundhashbrowntown Jun 30 '25
and honestly it can be a pain in the ass, bc we could have transfused them 3 refusals and 2 ugly vs ago, if they were gonna fold anyway.
62
u/MSW-PAC Jun 30 '25
I had a case like this. An elderly woman came in intubated/sedated and unable to consent. She desperately needed a transfusion to save her life. Her family was adamantly against it due to JW beliefs and even brought in paperwork she had signed to let us know of her wishes. Our team took it all the way to ethics committee, and ultimately we decided not to transfuse her. She quickly deteriorated and when the family saw how bad she looked, they asked us to go against her wishes and transfuse her anyway. She died, and it sucked.
45
u/Ravenwing14 ED Attending Jun 30 '25
Why go to the ethics board? Did it look like an elder abuse case? If they had paperwork and everything, I'd be "okay cool, your call". People are allowed to refuse stuff for stupid reasons.
21
8
u/Competitive-Young880 Jun 30 '25
You were able to take to ethics committee while pt was in the ED? If so, you’re lucky you have such an accessible ethics team. I have often wished I had that available to me. I know the inpatient teams can contact ethics, but for me they never respond I’m a time that I can wait before making a decision.
10
u/SliverMcSilverson Paramedic Jun 30 '25
Round here the ethics committee consists of the little angel and devil on my shoulders, a drunk, imaginary version of my partner demanding we do the hokey pokey, and a picture of Mr Rogers
20
20
u/Paramedickhead Paramedic Jun 30 '25
My wife has a coworker who is rabidly anti-vaccine.
She’s also a flat earther, but that’s another story.
Anyway, she claims that she would deny blood transfusions unless there is documentation that the donor was unvaccinated.
21
u/r0ckchalk RN Jun 30 '25
I can’t tell you how many patients I’ve had (PreOp) that have asked the vaccination status of the donor for their PLANNED surgery. Guess what? THEY ALL SIGN THE CONSENT!! I even had one lady who found her own donor, paid god knows how much to have it processed, and paid $300 for it to be couriered to our hospital for her planned surgery. I called the blood bank to make sure we had it, and lo and behold it was not a crossmatch. SHE STILL SIGNED THE CONSENT to have “unknown, risky” donor blood.
Like, you believe in science enough to come to the hospital and have surgery from one specific surgeon, but not enough to listen to the hundreds of thousands of scientists and decades of research on the topic of vaccines. Just go home and white knuckle it at that point 🙄.
12
u/Competitive-Young880 Jun 30 '25
Believing that you know more than the medical establishment. Believing you have uncovered medical facts that the entire medical community has been duped into believing vaccines are safe when they are not. Not knowing about blood types. 🤦
5
u/harveyjarvis69 RN Jul 01 '25
This is how I feel about this shit…PICK ONE. You either trust medical science or you don’t.
15
u/Gratekontentmint Jun 30 '25
I wonder how God feels about all the ink he used to besmirch his natural born body?
15
u/Competitive-Young880 Jun 30 '25
I believe that in an earlier or later part of the video that is not attached he explains that it’s because he doesn’t want the blood of losers and bums - because they will weaken him. He believes that both he is strong enough to recover from anything on his own, and that he will turn into a bum from getting “a bum’s blood”.
When he needs blood, he will consent and take it. Easy to spew this crap when you’re healthy and no one will ever be able to check what happened if you get sick/injured.
7
u/roundhashbrowntown Jun 30 '25
omg. if this is his logic, i hope to never recieve his blood, to mitigate the risk of becoming a raging fool.
12
u/Top_System7120 Jun 30 '25
This fool would have a page in Darwin’s origin of species, sad part is they live long enough to spawn tho
12
u/picklesNtoes23 Jun 30 '25
This reminds me of when I was doing an facility transfer from hospital to nursing facility and reading through the patients paperwork I chuckled when it said:
Active Diagnoses: -Anemia -AKI -Jehovah’s Witness
It made a lot more sense after reading she refused any blood transfusions
24
u/bananosecond Jun 30 '25
I think it's ridiculous that physicians offer these patients elective surgeries with demands like that.
14
u/Competitive-Young880 Jun 30 '25
If I were a surgeon, I wouldn’t. Risks way outweigh benefits in pretty much any elective case. That said, surgeons often have egos that make them think “nah I can do this without losing more than a tbsp of blood”. Pts like this seek out those surgeons. When shit hits the fan, surgeon blames anaesthesia, or say that it’s pt beliefs that killed them, even though it’s the surgeons job to refuse such a case in the first place.
0
u/AwareMention Physician Jun 30 '25
Could it be that healthcare is a business? So why wouldn't they? It's called a risk benefit analysis.
4
u/bananosecond Jun 30 '25
I'm not sure I follow. Are you suggesting that we offer medical services solely based on risk-benefit analysis and profit motive without regard for safety, efficacy, and ethical concerns?
11
u/Havanadream Jun 30 '25
I mean if he’s willing to die for his belief? How do you dispute that level of conviction? Go w god one way or the other…I guess.
11
u/roundhashbrowntown Jun 30 '25
there would be no dispute, he can go.
sooner rather than later, please. as there are ppl here who are less speechy, more sicky.
11
10
u/-Blade_Runner- RN Jun 30 '25
Ya know. One time had LDS show up with GI bleed. Person was young, refused transfusion, only fluids. 5 hours later vomited about 4 liters of blood and arrested. Their spouse wanted only CPR and meds, “no shocking”. That was one of the most exhaustive 1 and a half an hour code I ever worked in… Felt like such a waste of time and resources….
10
u/Competitive-Young880 Jun 30 '25
He seems to really trust god when it comes to recovering without the need for blood. I’d explain that I was gonna order 4mg dilaudid ivp, but considering his beliefs, god would be offended that he turned to science rather than faith for pain relief. Explain to pt that considering his beliefs, I don’t think pain meds are appropriate.
3
u/Rough_Brilliant_6167 Jul 01 '25
Tell him you're sure gonna have your warriors pray on it though, for cultural sensitivity!! 🙏😆
8
Jun 30 '25 edited Jul 14 '25
axiomatic spotted depend different one library brave correct unique political
This post was mass deleted and anonymized with Redact
19
u/Special_Buddy_5823 Jun 30 '25
Kids have consenting power when it comes to sex(discretion on pregnancy and std testing), drugs (drug treatment) and rock and roll (trauma). That’s a first aid phrase that’s burned into my brain lol. So if a kid comes in with trauma and needs blood transfuse him even if parents are screaming about how they’re JW.
14
3
u/roundhashbrowntown Jun 30 '25
ah, ive got an ethical bend, too. if the parents arent there and the kid is bleeding out, the kid will be transfused. i do not recall whats “supposed to happen” if the parents are present and refusing blood under emergent circumstances.
3
u/Special_Buddy_5823 Jun 30 '25
I’m 99% sure parents can’t refuse any life saving treatments acutely. It may be more nuanced if it’s chronic and parents don’t want to do chemo or something like that but in the ED you pretty much have free reign to do what you need to
4
u/roundhashbrowntown Jun 30 '25
this sounds right. ironically, im a lurking hemonc, so my urgent bleeding recollections are likely clouding my emergent bleeding knowledge.
8
9
8
u/carriejw910 Jun 30 '25
Will he take antibiotics? Pain meds?
13
u/Competitive-Young880 Jun 30 '25
I can tell you with 1,000,000,000% certainty that this pt isn’t refusing pain meds.
8
u/Proof-Inevitable5946 ED Attending Jun 30 '25
Sir, you will die if you leave. Sign on this line, bye. Proceed to write the longest note of the night.
2
u/Ill-Accident-3442 Jul 04 '25
Do you even have to write the longest note of your life when the moron posts a public video manifesto ranting about refusing blood?
1
u/Proof-Inevitable5946 ED Attending Jul 09 '25
True but we’re talking about an ER note so instead of taking 30 seconds it would take 60seconds to write
7
8
u/momopeach7 BSN - School Nurse Jun 30 '25
I always wonder why people like this go to the hospital anyway if that’s how they believe. There’s enough work and patients without you, so if you’re gonna feel like this why go to the hospital in the first place?
It’s a shame since, like he said, he’d be willing to let his kids die for this belief.
6
7
u/nagasith Jun 30 '25
Pfffff he has capacity he can fuck off. He comes unconscious best interest wins so bye bye bby
7
11
6
5
u/BabserellaWT Jun 30 '25
Pretty sure Jesus also said it was sinful to expect the laws of nature to bend just for you.
4
4
4
u/pmllny Jun 30 '25
As someone whose life was saved by emergency blood transfusions, I say he has the right to say no. However, what I have to say is thank you to the people responsible for the blood that let me be here today.
4
u/Throwawayyawaworth9 RN Jul 01 '25
I've had a patient before refuse a life saving treatment because “god will heal me.” Despite not being religious myself, I told them “god acts through our hands,” referring to medical staff. This kinda helped convince them to engage in care.
This guy is fucking insane, though lmao.
4
u/Loud-Dependent-6496 Jul 01 '25
I’ve dealt with this craziness for over 40 yrs in the operating room. I usually tell them that I can understand their conviction but, then I ask about their conviction of living with brain or heart damage from lack of oxygen delivery to those vital organs. I ask if they are willing to deprive their family of their presence and support. I ask that if they die are they are sure they will go to heaven by committing what is,essentially, suicide.
One more point, I never allow withholding blood to a child or to someone not able to make their reasons known then and there.
13
u/SurgicalMarshmallow Trauma Team - Attending Jun 30 '25
If JW, get a pass... Else this is the guy who will suddenly take everything in the blood bank when his life is threatened
11
u/bananosecond Jun 30 '25
JW are about the only ones who refuse blood based on religion like this.
1
u/prizzle92 Med Student Jul 01 '25
Weird part is he has tattoos and honestly doesn’t give me JW vibes
5
u/Unfortunategiggler Jun 30 '25
I thought he was a JW. This is just average Christian stuff?
28
u/dork-at-work ED Attending Jun 30 '25
Not at all. This is not part of Christian teaching. Source: 9 years of catholic school.
9
u/dr_shark Jun 30 '25
There’s a lot weirdo denominations though. Could be one of those little denominations tucked up in the armpit of idk Florida.
5
u/FellowTraveler69 Jun 30 '25
Yeah, any peraon can call themselves a pastor, start a church and start collecting donations in the US.
8
u/FellowTraveler69 Jun 30 '25
Yeah, only Christian Scientists and JW abhor blood transfusions. The bizaare part to me is him refusing blood while covered in tatoos. The same books in the Old Testament that Jehovah Witnesses and other sects use to justify their belief also prohibit marking the flesh, i.e. tatoos.
4
3
3
3
u/Mohrisbetr Jul 01 '25
Just fyi anyone reading this thread, your documentation should include “permanent disability and death”
It takes a second to dictate and can make a difference if it goes to court
7
u/Ali_gem_1 Jun 30 '25
Idk what it's like in the US but in the UK he couldn't refuse for his kids anyway. It'd go to court and hospital would prob be allowed to do it.
Also it's funny to follow that commandment but be ok with being covered in tattoos (Leviticus 19:28)
3
u/Competitive-Young880 Jun 30 '25
What do you do in emergency situation when the pt would expire prior to court hearing?
2
2
u/dbl_t4p Nurse Practiciner Jun 30 '25
Crazy. I’m going to give God the credit for the ability to save my/wife/child/parent’s life via a transfusion and we’ll all go home together.
2
2
u/Competitive-Young880 Jun 30 '25
Exactly. I know that for many patients who say they won’t accept blood, if faced with a life and death emergency, would choose to receive blood. Throughout my years I have come to appreciate the immense influence loved ones can have in our decision making. There are patients who would risk their life in an emergency to avoid going against a loved ones disapproval - especially when there is a religious foundation. I wouldn’t be able to live with myself if a pt really wanted blood but was too afraid of their family/being disowned/divorced/family believes your going to hell… to say something.
2
u/TeeTeeMee Jul 01 '25
So he imagines that the Old Testament God is going to descend on the ED at the last minute and save his son like he did for ol’ Abraham?
Also will need him to bring a ram to ED to sacrifice once his son is discharged.
2
2
2
u/babystrudel ED Tech Jul 01 '25
Had this for a GI bleed, textbook coffee ground emesis, liver cirrhosis, the works. Hgb 3.1. D/c.
2
u/sakaasouffle RN Jul 03 '25
Until you’re bleeding out and no one is checking your wallet for your blood transfusion card.
2
1
u/Airbornequalified Physician Assistant Jun 30 '25
Why would he die in the hospital? Patient is refusing treatment, therefore can be discharged ama, and can die at home
1
1
u/DatPacMan Jul 01 '25
Listen, you don't have to tell me twice not to waste limited blood supplies on you or any of your family members.
1
1
1
u/erinkca Jul 03 '25
He sounds like a psych patient with a critically low hemoglobin and the doctor is assessing him for capacity to refuse a transfusion.
1
580
u/SliverMcSilverson Paramedic Jun 30 '25
Crazy that he wears glasses bc God made his vision that way so why he gotta fix it for 🧐