Preferences for Resuscitation and Intubation Among Patients With Do-Not-Resuscitate/Do-Not-Intubate Orders

Jesus, John E.; Allen, Matthew B.; Michael, Glen E.; Donnino, Michael W.; Grossman, Shamai A.; Hale, Caleb; Breu, Anthony C.; Bracey, Alexander; O'Connor, Jennifer L.; Fisher, Jonathan

doi:10.1016/j.mayocp.2013.04.010

Cited by 37 publications

(21 citation statements)

References 36 publications

(56 reference statements)

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“…Based on his goals and values, this patient may see a trial of MV as acceptable. One recent study supports this hypothesis, as 28% of hospitalized patients with a combined DNR/DNI order would accept a trial of MV for pneumonia . If the genesis of these orders was our desire to ensure that patients' autonomous preferences are respected, we must actually know those preferences, and those preferences should be based on adequate information about the expected outcomes, highlighting the differences outlined above.…”

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confidence: 99%

Differentiating DNI from DNR: Combating code status conflation

Breu

Herzig

2014

Journal of Hospital Medicine

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Goals of care discussions, including those focused on code status, are meant to foster autonomous decision-making. Unfortunately, these discussions often conflate decisions regarding the use of cardiopulmonary resuscitation for cardiac arrest and mechanical ventilation for pre-arrest respiratory failure. They also exclude discussions of outcomes, particularly those associated with pre-arrest respiratory failure. In doing so, they may fail in their intention of extending patient autonomy.

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confidence: 99%

Differentiating DNI from DNR: Combating code status conflation

Breu

Herzig

2014

Journal of Hospital Medicine

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“…However, even if a patient has a poor prognosis, it does not always mean that he/she does not wish to be resuscitated or receive aggressive treatment. As the final decision on DNAR orders will differ according to the attitude of the individual patient,10, 11, 12, 13 it is essential to confirm each and every patient's intentions wherever possible. Apart from these diseases and background factors, patients with sequelae of cerebrovascular disease or dementia or patients in a persistent vegetative state may lack decision‐making capability.…”

Section: Discussionmentioning

confidence: 99%

Do not attempt resuscitation order in Japan

Inokuchi

Kobayashi

Ohkubo

2017

Acute Medicine & Surgery

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AimIn Japan, the do not attempt resuscitation (DNAR) order is practised routinely even though no related laws or guidelines exist. This study aimed to clarify the current status of DNAR, reveal existing DNAR‐related issues, and improve the application of DNAR.MethodsA questionnaire survey of medical institutions in Kanagawa Prefecture (total population, 9,120,000) about the current status of DNAR was carried out.ResultsThe results showed that DNAR has been practised at approximately 90% of the hospitals surveyed, but only about 30% have developed in‐hospital DNAR guidelines. Approximately 80% of the hospitals do not involve patients in the decision on their own DNAR orders. Because the DNAR order has not been legislated, it is often unclear whether to resuscitate patients when a request for an ambulance is made for a cardiac arrest at home.ConclusionIt is necessary for prefectures, municipalities, and local medical control authorities to take the initiative in establishing an ordinance on DNAR orders and developing guidelines.

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“…It was first introduced to medical literature in 1976. [3] It is frequently implemented for terminal cancer patients and elderly patients with irreversible neurological disorders. This decision is usually ordered by patient's relatives.…”

Section: Introductionmentioning

confidence: 99%

“…Decision can only be considered if accepted by doctors and ethical committees of the hospital. [3] In severely burned patient, third-degree burns encompass nearly all of the skin. Inhalation injury may also be present.…”

Section: Introductionmentioning

confidence: 99%

Can we make an early “do not resuscitate order” decision in severe burn patients?

Yüce

Acar²,

Erkal³

et al. 2016

Ulus Travma Acil Cerrahi Derg

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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.

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Preferences for Resuscitation and Intubation Among Patients With Do-Not-Resuscitate/Do-Not-Intubate Orders

Cited by 37 publications

References 36 publications

Differentiating DNI from DNR: Combating code status conflation

Differentiating DNI from DNR: Combating code status conflation

Do not attempt resuscitation order in Japan

Can we make an early “do not resuscitate order” decision in severe burn patients?

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