Cachexia - Royal Blackburn hospital quiz

By Value hunter on Feb 25, 2015 | In In real life, Wondering

EPCRC guidelines recommend that the enteral route should be used in certain patient groups (eg, to reverse weight loss) in patients with Cachexia

Patient admitted to Royal Blackburn Hospital with a rash to arms and legs. Within 24 hours (and no tests carried out) they are diagnosed with "Terminal Cachexia" - NICE guidelines state that the patient should be enternal fed (tube through nose directly into the stomach).
Would you...

A. Not tell the family, keep the patient in hospital for a further 2 weeks and continue to try and feed orally (with just 6 out of a possible 30 meals)?

B. As A, then send the patient home, with supply of protein shakes and tell family to try and get them to eat more, the family then has to wait months after the patient's death for the hospital notes before finding out any information about this diagnosis and lack of treatment as set out by NICE guidelines?

C. Follow NICE guidelines for enternal feeding by tube into stomach and notify the family at the first instance this diagnosis was made?

Royal Blackburn Hospital chose B

Royal Blackburn hospital now state, "NICE guidelines are just guidelines and do not need to be followed"

What would you do?