R. Brown et al., DECISION-MAKING IN RESUSCITATION FROM OUT-OF-HOSPITAL CARDIAC-ARREST, Journal of accident & emergency medicine, 13(2), 1996, pp. 98-100
Citations number
8
Categorie Soggetti
Emergency Medicine & Critical Care","Medicine, General & Internal
Objective-To determine which factors are perceived by senior house off
icers (SHOs), consultants, and medical registrars in accident and emer
gency (A&E) medicine as being important in decision making. Methods-13
2 SHOs in A&E medicine, of 172 attending an induction course at the st
art of their job (77%), completed a questionnaire relating to 20 facto
rs of possible importance in decision making; 73 completed the questio
nnaire at six weeks and 55 at six months. Ten medical registrars and 3
1 consultants in A&E medicine also completed the questionnaire. Result
s-The SHOs were able to recognise bystander cardiopulmonary resuscitat
ion and early advanced I support, as well as the presence of ventricul
ar fibrillation, as important prognostic factors. There was considerab
le variation in all three groups in their opinions on the importance o
f the other factors considered. There was no obvious change in SHO res
ponses over the period of training. Conclusions-Lack of guidelines may
result in more patients receiving resuscitation than are salvageable,
as doctors maintain a low threshold for continuing resuscitation to a
void missing potential survivors. A decision making algorithm is recom
mended.