For professionals

Introduction

In the case of a 52-year-old man in a vegetative state, who had been resuscitated after a cardiac arrest in which no witnesses were present, the nursing home doctor took over responsibility for the total treatment in a transmural switching department in the hospital. Through his systematic, multidisciplinary working method, he was in charge of the complex situation in which many (para)medics were involved. When a respiratory infection occurred as a complication shortly after taking over the patient, the nursing home doctor was able to make a well-considered decision to abstinence from medical treatment based on the treatment plan built up in a short time and contact with the family.

In the prevention of a hopeless vegetative state, it turns out to be difficult in practice to find the right time to stop medical treatment, including tube feeding. The case described shows how hospital specialists can work together with nursing home doctors in the so-called 'wait-and-see phase' in the course of a vegetative state. Making use of these transmural cooperation opportunities, with early input of knowledge and experience about the long-term course of the vegetative state, makes it possible to prevent a hopeless vegetative state.