Multiple Cardiopulmonary Resuscitation Attempts in a Community Hospital

Abstract

Adjusting medical care based on futility assessment in patients with chronic illness who survive CRA is often neglected, but crucially relevant step in the optimization of health care system management.

Mobile extracorporeal membrane oxygenation service for severe acute respiratory failure – A review of five years of experience

“…8,9 Each decision was also consulted with the on-call intensivist at the specialist ECMO centre highlighting the critical value of a specialist opinion and holistic approach in clinical decision making especially with regard to unique, controversial and highly specialist services such as ECMO. [17][18][19] Limitations This study had several limitations. Firstly, an evaluation of six years of experience in a single retrospective observational study fails to appreciate change of practice as a result of technological developments, increased experience of the retrieving team and advancement of knowledge about aetiology and management of severe refractory ARDS, such as introduction of protective ventilation and prone positioning.…”

Medical futility regarding cardiopulmonary resuscitation in in-hospital cardiac arrests of adult patients: A systematic review and Meta-analysis

“…1). 24,26,27,29,34,35,39,42,45,47,48 and in European countries such as Sweden, 4,28,31,49 and England. 40,41,44 Study sample sizes ranged from 29 to 96,499 per trial.…”

Communication challenges in end-of-life decisions

“…A recent study on patients in the ICU found that more than 10% of patients received treatment perceived as futile by their treating clinicians [47]. In the context of EOL care, medical futility often refers to interventions that might prolong life, but in which the chance of a benefit for the patient is extremely small and by far outweighed by the potential risks, harms and suffering [47][48][49]. Such situations are challenging for clinicians and the clinical team, who know the potential burden and distress resulting from a futile intervention for patients and relatives [50,51].…”