[The availability of living wills in an interdisciplinary emergency department: results of a patient survey]. / Verfügbarkeit von Patientenverfügungen in einer interdisziplinären Notaufnahme.

INTRODUCTION: Despite an increasing attention to living wills, the effects of such living wills on patient care in the emergency departments remains unknown. MATERIAL AND METHODS: All patients who were admitted to our emergency department between September 24th, 2014 and November 23th, 2014 were asked, whether they have signed living wills previously and if so, whether they have it on hand at admission. RESULTS: 496 patients (229 men (46.2 %), 267 women (53.8 %)) with a mean age of 64.9 ±â€…18.8 years were included in this survey. 138 patients (27.8 %) had a living will but only 16 patients (3.2 %) had it on hand.Altogether, the existence of living wills increased with an increasing patient`s age; only 5 of 117 patients aged 50 years old or younger (4,3 %) had a living will, but 133 of 379 patients older than 50 years (35,1 %). DISCUSSION AND CONCLUSION: Despite an obviously broad acceptance of living wills especially in the elderly population, there are hardly any consequences on the daily patient care in an emergency department by now, as hardly any patient has hers or his living will on hand at admission. We therefore see the need for further educational work to guarantee that living wills get adequate priority in patient care at emergency departments.

[Who observes out-of-hospital cardiac arrests in Germany?]. / Wer beobachtet in Deutschland den außerklinischen Herzstillstand?

INTRODUCTION: It still remains unknown why there are so poor rates of lay-resuscitation in Germany. We wanted to find out who observes the out-of-hospital cardiac arrests (OHCA) in Germany. PATIENTS AND METHODS: All patients who were admitted in our hospital between January, 1st 2008 and December, 31st 2013 following non-traumatic OHCA were identified and the patients' data were stored on a central data base. RESULTS: Data on 204 patients (124 male [60,8 %], 80 female [39,2 %], aged 69,1 ±â€Š14,2 years [range 18-97 years]) were analysed. Altogether, 137 OHCA were witnessed (67,2 %): 83 cases (40,7 %) by laypersons and 54 further cases (26,5 %) by medical professionals. Among laypersons, most OHCA were witnessed by the partner (17,2 %) and further relatives (11,8 %) but resuscitation rates among partner (3,9 %) and relatives (5,9 %) were poor. Altogether, immediate resuscitation attempts were started in 93 patients, hereunder in 35 cases (17,2 %) by layperson and 58 cases (28,4 %) by medical professionals. CONCLUSION: Rates of lay-resuscitation remain poor despite high rates of witnessed events: unfortunately, especially partner and relatives act too rarely. However, the motivation to approve their knowledge in first-aid and resuscitation might rise among lays if they are informed that it is more likely to observe a partner's or relative´s OHCA than a stranger's.