Finding language when there are no words

During the current pandemic, physicians are findings themselves interfacing with the public and talking about topics they never thought they would have to consider.  One way to prepare for this is to develop a library of phrases ahead of time which can be used in the appropriate context. It can also be helpful to generate analogies to common objects/systems to assist the general public in understanding critical care concepts.


One analogy I use to explain low blood pressure in sepsis, vasodilation, and vasopressors is to ask the patient or their family to think of the water pressure in their house.  If I doubled the size of the pipes, the water pressure would decrease. But if I can give medications to make the pipes smaller that would increase the pressure.


For pulmonary embolism, I explain how the right ventricle is only a small pump for the workhorse of the heart, the left ventricle (no offense to all the RV physiology fans out there).  When the pipes leaving the primer pump get clogged, it has to work a lot harder to get the blood to the main pump. We give blood thinners to keep the clog from getting bigger and sometimes we use medications or procedures to try and remove the clog.


VitalTalk, an organization which teaches communication with patients and families about serious illness has released a free, vetted, crowd-sourced a library of phrases which can be used to talk about the current pandemic.  They include topics like triage decisions, end of life decisions, and even ways to check in when we talk to ourselves. Before your next shift, try some of the phrases they suggest - you might find yourself adopting them in how you communicate with your patients and families and your colleagues.