Articles Tagged With: CPR
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Most ED Patients Overestimate Success of CPR
Emergency physicians routinely need to ask patients about their wishes for care if they go into cardiac arrest.
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Ventilation and Oxygenation Considerations During and After Cardiopulmonary Resuscitation
With a multitude of recommendations spanning from monitoring during cardiopulmonary resuscitation (CPR) to post-arrest targeted temperature management, the specific focus of this article is to review considerations related to ventilation and oxygenation during and after CPR.
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ECMO-Supported CPR Disappoints for Treating Out-of-Hospital Cardiac Arrest
For patients with out-of-hospital cardiac arrest that was refractory to initial resuscitation efforts, adding extracorporeal membrane oxygenation to standard CPR did not result in a significant improvement in survival with favorable neurologic outcome.
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Black and Hispanic People Are Less Likely to Receive Out-of-Hospital Bystander CPR Regardless of Cardiac Arrest Location
Based on a large U.S. registry that included information on witnessed out-of-hospital cardiac arrests, Black and Hispanic people were less likely than white people to receive bystander cardiopulmonary resuscitation, independent of the neighborhood where the cardiac arrest occurred.
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‘Informed Assent’ for CPR Is Reasonable Approach for Some Hospitalized Patients
This concept was developed to satisfy the right of physicians to initiate DNR orders in futile situations and their duty to communicate to patients and lawful surrogates. Through informed assent, physicians state they will write a DNR order because it would be futile and harmful to the patient to attempt CPR in their current serious illness.
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Ethical Considerations When Nurses Perform ‘Slow Codes’ at End of Life
On some occasions, limited resuscitation efforts occurred without the family’s knowledge. Not all resuscitation measures are medically beneficial, and clinicians often must decide in the moment if they are clinically appropriate to perform.
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Study: More Than Half of DNR ED Patients Resuscitated Against Their Wishes
Of 419 cardiac arrest patients, 65 were DNR status. Of this group of DNR patients, 38 were resuscitated against their wishes. Not adhering to a patient’s wishes not only violates their autonomy, but it is arguably not acting in the patient’s best interest — and may in fact be causing them harm.
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For Some Patients with Valid DNRs, Confusion Results in Unwanted CPR
Some DNR orders were not documented anywhere in the medical record. ED staff sometimes failed to recognize DNR orders that were documented. Other patients had advance directives, but no valid DNR order.
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Some Code Status Discussions Are Rushed, Incomplete, or Misleading
Learning how to engage in code status conversations is as important as learning how to perform medical procedures. Clinicians would not ask patients in completely neutral terms whether they want a procedure that has no chance of working or would inflict serious harm. Any conversation around resuscitation status should take into account patients' goals and values, what is important to them in life, and the minimum acceptable quality of life.
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Some Hospitalized Patients Admitted to ICU, Contrary to Stated Wishes
Research has demonstrated that completed Physician Orders for Life-Sustaining Treatment (POLST) forms can help people with chronic illness avoid unwanted hospitalizations and CPR. However, there is more to learn about what happens when patients with POLST forms are admitted to the hospital near the end of life.