Clinical Decision Rules for Termination of Resuscitation in Out-of-Hospital Cardiac Arrest

Sherbino, Jonathan; Keim, Samuel M.; Davis, Daniel P.

doi:10.1016/j.jemermed.2009.08.002

Cited by 13 publications

(3 citation statements)

References 13 publications

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“…Validation studies related to basic life support have been conducted to identify patients with no probability of survival. One study found that following rules for the termination of basic life support had a positive predictive value for death of 99.5% and decreased the transfer of patients to hospital by 63% [68]. …”

Section: Resultsmentioning

confidence: 99%

“…Reasons include unexpected hospitalisation contrary to home death as planned as a result of the carer not having sufficient resources and an inability to control unpleasant symptoms. As a result the GP is often bypassed and the patient is admitted to an acute hospital where EDs tend to perform acute resuscitation and transfer to general wards or intensive care units (ICUs) [7, 24, 26, 53, 68, 70, 77, 79–85]. …”

Section: Introductionmentioning

confidence: 99%

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A Literature Review on Care at the End-of-Life in the Emergency Department

Forero

McDonnell

Gallego

et al. 2012

Emergency Medicine International

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The hospitalisation and management of patients at the end-of-life by emergency medical services is presenting a challenge to our society as the majority of people approaching death explicitly state that they want to die at home and the transition from acute care to palliation is difficult. In addition, the escalating costs of providing care at the end-of-life in acute hospitals are unsustainable. Hospitals in general and emergency departments in particular cannot always provide the best care for patients approaching end-of-life. The main objectives of this paper are to review the existing literature in order to assess the evidence for managing patients dying in the emergency department, and to identify areas of improvement such as supporting different models of care and evaluating those models with health services research. The paper identified six main areas where there is lack of research and/or suboptimal policy implementation. These include uncertainty of treatment in the emergency department; quality of life issues, costs, ethical and social issues, interaction between ED and other health services, and strategies for out of hospital care. The paper concludes with some areas for policy development and future research.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Literature Review on Care at the End-of-Life in the Emergency Department

Forero

McDonnell

Gallego

et al. 2012

Emergency Medicine International

View full text Add to dashboard Cite

show abstract

“…3 If we treat BLS-TOR as a test, a "positive" result generally predicts death, but unlike other clinical tests its specificity must be 100% because a false positive result by definition represents the wrongful death of a neurologically intact survivor of cardiac arrest. 4 Validation trials of BLS-TOR have almost always found a handful of survivors who would have been declared dead by the rule. For instance, the original BLS-TOR study of 1240 cardiac arrests advised no transport for 776 (63%) patients, four of whom survived to hospital discharge.…”

Section: Yes-bruce D Adamsmentioning

confidence: 99%