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https://www.readbyqxmd.com/read/28625532/emergency-department-do-not-resuscitate-order-in-patients-with-spontaneous-intracerebral-hemorrhage
#1
Ju-Sing Fan, Hsien-Hao Huang, Yen-Chia Chen, Chorng-Kuang How, David Hung-Tsang Yen
OBJECTIVES: To explore the determinant factors and prognostic significance of emergency department do-not-resuscitate (ED-DNR) orders for patients with spontaneous intracerebral hemorrhage (SICH). METHODS: Consecutive adult SICH patients treated in our ED from January 1, 2012 to December 31, 2016 were selected as the eligible cases from our hospital's stroke database. Patients' information was comprehensively reviewed from the database and medical and nursing charts...
June 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28622155/triad-ix-can-a-patient-testimonial-safely-help-ensure-prehospital-appropriate-critical-versus-end-of-life-care
#2
Ferdinando Mirarchi, Christopher Cammarata, Timothy E Cooney, Kristin Juhasz, Stanley A Terman
OBJECTIVE: The present study sought to assess the clarity of Physician Orders for Life-Sustaining Treatment (POLST) or Living Will (LW) documents alone or in combination with a video message/testimonial (VM). METHODS: Emergency medical services (EMS) personnel responded to survey questions about the meaning of stand-alone POLST and LW documents and those used in conjunction with emergent care scenarios. Personnel were randomized to receive documents only or documents with VM...
June 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28620153/premature-labor-and-neonatal-septicemia-caused-by-capnocytophaga-ochracea
#3
Abdullah A Alhifany, Thamer A Almangour, Deanne E Tabb, David H Levine
BACKGROUND Capnocytophaga ochracea is a gram-negative anaerobic organism commonly found in human oral flora. It is characteristically sensitive to beta-lactams and resistant to aminoglycosides. CASE REPORT A 23-year-old woman presented with lower abdominal pain and was admitted for premature labor at 24-weeks of gestation. At presentation, the cervix was closed and the membrane was intact; however, contractions continued, the membrane subsequently ruptured before receiving any steroids or magnesium, and the mother gave birth to a 540-gram female baby...
June 16, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28614079/do-not-resuscitate-with-no-surrogate-and-no-advance-directive-an-ethics-case-study
#4
Jamie Diamond, Umesh Gidwani, Rosamond Rhodes
Do-not-resuscitate (DNR) orders are typically signed by physicians in conjunction with patients or their surrogate decision makers in order to instruct healthcare providers not to perform cardiopulmonary resuscitation (CPR). Both the medical literature and CPR guidelines fail to address when it is appropriate for physicians to sign DNR orders without any knowledge of a patient's wishes. We explore the ethical issues surrounding instituting a two-physician DNR for a dying patient with multiple comorbidities and no medical record on file, no advance directives, and no surrogate decision maker...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28602096/access-to-palliative-care-for-patients-undergoing-mechanical-ventilation-with-idiopathic-pulmonary-fibrosis-in-the-united-states
#5
Barret Rush, Landon Berger, Leo Anthony Celi
OBJECTIVE: The utilization of palliative care (PC) in patients with end-stage idiopathic pulmonary fibrosis (IPF) is not well understood. METHODS: The Nationwide Inpatient Sample (NIS) was utilized to examine the use of PC in mechanically ventilated (MV) patients with IPF. The NIS captures 20% of all US inpatient hospitalizations and is weighted to estimate 95% of all inpatient care. RESULTS: A total of 55 208 382 hospital admissions from the 2006 to 2012 NIS samples were examined...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28595818/do-not-resuscitate-orders-and-high-risk-pediatric%C3%A2-surgery-professional-nuisance-or%C3%A2-medical%C3%A2-necessity
#6
Lauren M Baumann, Kibileri Williams, Fizan Abdullah, Richard J Hendrickson, Tolulope A Oyetunji
BACKGROUND: There is a paucity of data in the literature regarding end-of-life care and do-not-resuscitate (DNR) status of the pediatric surgical patient, although invasive procedures are frequently performed in very high risk and critically ill children. Despite significant efforts in adult medicine to enhance discussions around end-of-life care, little is known about similar endeavors in the pediatric population. METHODS: A retrospective review of the National Surgical Quality Improvement Program Pediatric database was performed...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28594585/impact-of-palliative-medicine-involvement-on-end-of-life-services-for-patients-with-cancer-with-in-hospital-deaths
#7
Alison Wiesenthal, Debra A Goldman, Deborah Korenstein
PURPOSE: Palliative care (PC) has been shown to improve the quality of care and resource utilization for inpatients. We examined the relationship between PC consultation before and during final admission and patterns of care for dying patients at our tertiary cancer center. METHODS: We retrospectively reviewed adult patients with solid tumor cancer with a length of stay ≥ 3 days who died in hospital between December 2012 and November 2014. We recorded services, including laboratory testing, imaging, blood products, medications, diet orders, do not resuscitate orders, and consultations, delivered within 3 days of death...
June 8, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28557015/palestinian-community-perceptions-of-do-not-resuscitation-order-for-terminally-ill-patients-a-qualitative-study
#8
Intima Alrimawi, Ahmad Rajeh Saifan, Raghad Abdelkader, Abdul-Monim Batiha
AIM AND OBJECTIVES: This study aims to illustrate the Palestinian community's views, opinions and stances about the concept of do not resuscitate (DNR) for terminally ill patients. BACKGROUND: DNR orders are practiced in many countries worldwide, but there is no consensus on their practice in the Middle East. DNR orders may be applied for terminally ill pediatric patients. Some studies have been conducted describing people's experiences with these DNR orders. However, few studies have considered community perspectives on DNR orders for terminally ill patients in Palestine...
May 30, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28555783/implementation-of-a-critical-care-outreach-service-a-qualitative-study
#9
A Jeddian, A Lindenmeyer, T Marshall, A F Howard, L Sayadi, A Rashidian, N Jafari
AIM: The aim of this study was to explore hospital staff perceptions of the perceived challenges and outcomes of implementing a critical care outreach service. BACKGROUND: A nurse-led critical care outreach service was designed and implemented to identify and treat acutely ill patients in a large tertiary care hospital in Iran. METHODS: A qualitative analysis of data from two focus groups and seven interviews was carried out using conventional content analyses techniques...
May 29, 2017: International Nursing Review
https://www.readbyqxmd.com/read/28540112/comparison-of-postoperative-outcomes-in-elderly-patients-with-a-do-not-resuscitate-order-undergoing-elective-and-nonelective-hip-surgery
#10
Anair Beverly, Ethan Y Brovman, Richard D Urman
PURPOSE: Emergency hip surgery generally has worse outcomes than elective hip surgery, even when adjusted for patient and surgical factors. Do-not-resuscitate (DNR) status patients are typically at higher perioperative risk and undergo a narrow range of surgical procedures. We aimed to compare the outcomes after hip surgery of differing degrees of urgency in this cohort. MATERIALS AND METHODS: Using National Surgical Quality Improvement Program (NSQIP) data, we conducted univariate and multivariate analyses comparing outcomes of DNR status patients after emergency and nonemergency hip surgery (2007-2013)...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28534181/assessing-decision-making-capacity-for-do-not-resuscitate-requests-in-depressed-patients-how-to-apply-the-communication-and-appreciation-criteria
#11
Benjamin D Brody, Ellen C Meltzer, Diana Feldman, Julie B Penzner, Janna S Gordon-Elliot
The Patient Self Determination Act (PSDA) of 1991 brought much needed attention to the importance of advance care planning and surrogate decision-making. The purpose of this law is to ensure that a patient's preferences for medical care are recognized and promoted, even if the patient loses decision-making capacity (DMC). In general, patients are presumed to have DMC. A patient's DMC may come under question when distortions in thinking and understanding due to illness, delirium, depression or other psychiatric symptoms are identified or suspected...
May 22, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28523117/evaluation-of-pediatric-residents-attitudes-toward-ethical-conflict-a-cross-sectional-study-in-tehran-iran
#12
Maliheh Kadivar, Marjan Mardani-Hamooleh, Shiva Shayestefar
Ethical conflicts are recognized as critical aspects in assessing competence in clinical communication. Moreover, pediatrics residents may face more problems, compared to other disciplines; due to the specific characteristics of the age group receiving services as well as the presence of their families. This study has been conducted with the aim of determining the attitude and perspective of pediatric residents toward ethical conflicts in the field of pediatrics. This descriptive, cross-sectional study was carried out on all residents of Tehran University of Medical Sciences (90 residents), selected through census method, in 2014...
2017: Journal of Medical Ethics and History of Medicine
https://www.readbyqxmd.com/read/28508956/doctors-attitudes-towards-the-introduction-and-clinical-operation-of-do-not-resuscitate-orders-dnrs-in-ireland
#13
M O'Reilly, C M P O'Tuathaigh, K Doran
BACKGROUND: Do not resuscitate orders (DNRs) are documents which state that should a patient suffer from cardiopulmonary failure, resuscitation should not be attempted. Internationally, DNRs are often misunderstood and used inappropriately in a clinical setting. AIMS: The aim of this paper was to determine the current understanding of DNRs and their clinical operation among hospital doctors in Ireland. METHODS: A cross-sectional, questionnaire-based study was conducted involving doctors from the Cork teaching hospitals...
May 16, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28501114/evaluation-of-palliative-care-training-and-skills-retention-by-medical-students
#14
Priti P Parikh, Mary T White, Lynne Buckingham, Kathryn M Tchorz
BACKGROUND: Training in palliative and end-of-life care has been introduced in medical education; however, the impact of such training and the retention of skills and knowledge have not been studied in detail. This survey study examines long-term follow-up on end-of-life communication skills training, evaluation, and skills retention in medical students. MATERIALS AND METHODS: During the surgical clerkship, all third-year medical students received communication skills training in palliative care using simulated patients...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28489813/implementing-a-novel-model-for-hospice-and-palliative-care-in-the-emergency-department-an-experience-from-a-tertiary-medical-center-in-taiwan
#15
Tzu-Chieh Weng, Ya-Chun Yang, Ping-Jen Chen, Wen-Fu Kuo, Wei-Lin Wang, Ya-Ting Ke, Chien-Chin Hsu, Kao-Chang Lin, Chien-Cheng Huang, Hung-Jung Lin
Hospice and palliative care has been recognized as an essential part of emergency medicine; however, there is no consensus on the optimal model for the delivery of hospice and palliative care in the emergency department (ED). Therefore, we conducted a novel implementation in a tertiary medical center in Taiwan. In the preintervention period, we recruited a specialist for hospice and palliative medicine in the ED to lead our intervention. In the early stage of the intervention, starting on July 1, 2014, we encouraged and funded ED physicians and nurses to receive training for hospice and palliative medicine and residents of emergency medicine to rotate to the hospice ward...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28486318/asking-a-better-question-development-and-evaluation-of-the-need-for-trauma-intervention-nfti-metric-as-a-novel-indicator-of-major-trauma
#16
Jacob W Roden-Foreman, Nakia R Rapier, Luanna Yelverton, Michael L Foreman
Many existing metrics, such as Injury Severity Score (ISS), cannot fully describe many trauma patients because of comorbidities. This study developed and evaluated the Need For Trauma Intervention (NFTI) metric as a novel indicator of major trauma. The NFTI metric was developed from an analysis of 2,396 trauma patients at a Level I trauma center. Six commonly recorded registry variables were found to be indicative of major trauma and comprised the NFTI criteria: receiving packed red blood cells within 4 hr; discharge from the emergency department (ED) to the operating room within 90 min; discharge from the ED to interventional radiology; discharge from the ED to the intensive care unit (ICU) with an ICU length of stay (LOS) of 3 or more days; mechanical ventilation outside of procedural anesthesia within 3 days; or death within 60 hr...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28469984/do-not-resuscitate-brain-death-and-organ-transplantation-islamic-perspective
#17
REVIEW
Hassan Chamsi-Pasha, Mohammed Ali Albar
Muslim patients and families are often reluctant to discuss and accept fatal diagnoses and prognoses. In many instances, aggressive therapy is requested by a patient's family, prolonging the life of the patient at all costs. Islamic law permits the withdrawal of futile treatment, including life support, from terminally ill patients allowing death to take its natural course. "Do not resuscitate" is permitted in Islamic law in certain situations. Debate continues about the certainty of brain death criteria within Islamic scholars...
April 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28467581/can-we-make-an-early-do-not-resuscitate-decision-in-severe-burn-patients
#18
Yücel Yüce, Hakan Ahmet Acar, Kutlu Hakan Erkal, Erhan Tuncay
BACKGROUND: The present study was conducted to examine topic of issuing early do-not-resuscitate (DNR) order at first diagnosis of patients with severe burn injuries in light of current law in Turkey and the medical literature. DNR requires withholding cardiopulmonary resuscitation in event of respiratory or cardiac arrest and allowing natural death to occur. It is frequently enacted for terminal cancer patients and elderly patients with irreversible neurological disorders. METHODS: Between January 2009 and December 2014, 29 patients (3...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28441973/treatment-limiting-decisions-in-patients-with-severe-traumatic-brain-injury-in-a-norwegian-regional-trauma-center
#19
Annette Robertsen, Reidun Førde, Nils Oddvar Skaga, Eirik Helseth
BACKGROUND: Treatment-limiting decisions (TLD) for severe traumatic brain injury (sTBI) have been sparsely studied. This study determine prevalence, main reason for, categories and timing of TLDs in a Norwegian regional trauma setting. METHODS: A retrospective study of a 2-year cohort of 579 sTBI patients admitted to Oslo University Hospital (OUH). Prospectively collected data in the OUH Trauma Registry were combined with retrospective data from a chart review regarding TLDs...
April 26, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28436933/legal-briefing-new-penalties-for-ignoring-advance-directives-and-do-not-resuscitate-orders
#20
Thaddeus Mason Pope
No abstract text is available yet for this article.
2017: Journal of Clinical Ethics
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