• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Prehospital emergency care >Potential impact of a verbal prehospital DNR policy
【24h】

Potential impact of a verbal prehospital DNR policy

机译：院前DNR口头政策的潜在影响

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background. Forgoing resuscitation in prehospital cardiac arrest has previously required a written prehospital do-not-resuscitate (DNR) order. Some emergency medical services (EMS) agencies, including Los Angeles County (LAC), have implemented policies allowing surrogate decision makers to verbally request to forgo resuscitation. The impact of a verbal DNR policy is unclear, given the absence of information about how often cardiac arrest occurs at home, or in the presence of a family member. Objective. To determine the prevalence of written DNR forms, rate of resuscitation, location of cardiac arrest, andavailability of a family member in nontraumatic cardiac arrest prior to implementation of the new policy in LAC. Methods. All prehospital run sheets for nontraumatic cardiac arrest in LAC were reviewed for the first seven days of each month (August 2006January 2007) for DNR status, location of cardiac arrest, presence of family members, andwhether resuscitation was attempted. Results. Of the 897 cardiac arrests, 492 occurred at home, 111 in a public place, and93 in a nursing home (location was unknown for 201). Fifty-five patients (6) had a written DNR order, although it was not always available. Of these 55 patients, ten were resuscitated, the majority of the time because the family could not produce the paperwork. A family member was listed as present 29 of the time (261 of 897 cases). A medical history was obtained in an additional 465 cases (52), indicating that someone familiar with the patient's medical history was present more than half the time, even when a family member was not mentioned. Conclusions. A written DNR order is uncommonly used in the prehospital setting as a reason to forgo resuscitation in LAC. Even when family members state that the patient has a DNR order, patients are often resuscitated. A majority of cardiac arrests occurs at the patient's home, andin many cases in the presence of family members, some of whom may be able to express a patient's preferences regarding end-of-life care
机译：背景。院前心脏骤停前要进行复苏，以前需要书面的院前不复苏（DNR）命令。包括洛杉矶县（LAC）在内的一些紧急医疗服务（EMS）机构已实施政策，允许代孕决策者口头要求放弃复苏。由于缺乏有关在家中或有家人的情况下多久发生心脏骤停的信息，口头DNR政策的影响尚不清楚。目的。在LAC实施新政策之前，要确定书面DNR形式的患病率，复苏率，心脏骤停的位置以及家庭成员在非创伤性心脏骤停中的可用性。方法。在每个月的前7天（2006年8月，2007年1月），对LAC的所有非创伤性心脏骤停的院前手术单进行检查，以了解DNR的状态，心脏骤停的位置，家人的存在以及是否进行了复苏。结果。在897例心脏骤停中，有492例发生在家庭中，有111例发生在公共场所，还有93例发生在疗养院（201例的位置未知）。五十五名患者（6名）有书面的DNR指令，尽管并非总是可用。在这55名患者中，有10名被复苏，大部分时间是因为家庭无法出示文书。一位家庭成员被列为当时的29名（897例中的261例）。在另外465例病例中获得了病史（52），这表明熟悉患者病史的人出现的时间超过了一半，即使没有提及家人。结论。在院前环境中，通常不使用书面DNR命令作为放弃在LAC中进行复苏的原因。即使家人声明患者有DNR指令，也常常会使患者复苏。大多数心脏骤停发生在患者的家中，并且在许多情况下，在有家庭成员在场的情况下，其中一些人可能能够表达患者对临终护理的偏好

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号