Resuscitation (un-)wanted: Does anyone care? A retrospective real data analysis.
Resuscitation
; 198: 110189, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38522733
ABSTRACT
BACKGROUND AND OBJECTIVES:
In case of out-of-hospital cardiac arrest (OHCA) personnel of the emergency medical services (EMS) are regularly confronted with advanced directives (AD) and do-not-attempt-resuscitation (DNACPR) orders. The authors conducted a retrospective analysis of EMS operation protocols to examine the prevalence of DNACPR in case of OHCA and the influence of a presented DNACPR on CPR-duration, performed Advanced-Life-Support (ALS) measures and decision making. MATERIALS ANDMETHODS:
Retrospective analysis of prehospital medical documentation of all resuscitation incidents in a German county with 250,000 inhabitants from 1 January 2016 to 31 December 2022. Combined with data from the structured CPR team-feedback database patients characteristics, measures and course of the CPR were analysed. Statistic testing with significance level p < 0.05.RESULTS:
In total n = 1,474 CPR events were analysed. Patients with DNACPR vs. no DNACPR n = 263 (17.8%) vs. n = 1,211 (82.2%). Age 80.0 ± 10.3 years vs. 68.0 ± 13.9 years; p < 0.001. Patients with ASA-status III/IV n = 214 (81.3%) vs. n = 616 (50.9%); p < 0.001. Initial layperson-CPR n = 148 (56.3%) vs. n = 647 (55.7%); p = 0.40. Airway management n = 185 (70.3%) vs. n = 1,069 (88.3%); p < 0.001. With DNACPR CPR-duration initiated layperson-CPR vs. no layperson-CPR 1914 min (1043-2555 min) vs. 1240 min (0635-2003 min); p < 0.001.CONCLUSION:
In case of CPR EMS-personnel are often confronted with DNACPR-orders. Patients are older and have more previous diseases than patients without DNACPR. Initiated layperson-CPR might lead to misinterpretation of patients will with impact on CPR-duration and unwanted measures. Awareness of this issue should be created through measures such as training programs in particular to train staff in the interpretation and legal admissibility of ADs.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Ordens quanto à Conduta (Ética Médica)
/
Reanimação Cardiopulmonar
/
Serviços Médicos de Emergência
/
Parada Cardíaca Extra-Hospitalar
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article