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  • Piscator, EvaKarolinska Institutet (author)

Low adherence to legislation regarding Do-Not-Attempt-Cardiopulmonary-Resuscitation orders in a Swedish University Hospital

  • Article/chapterEnglish2021

Publisher, publication year, extent ...

  • Elsevier BV,2021
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:hb-26182
  • https://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-26182URI
  • https://doi.org/10.1016/j.resplu.2021.100128DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:234223385URI
  • https://gup.ub.gu.se/publication/306178URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Background The ethical principles of resuscitation have been incorporated into Swedish legislation so that a decision to not attempt cardiopulmonary resuscitation (DNACPR) entails (1) consultation with patient or relatives if consultation with patient was not possible and documentation of their attitudes; (2) consultation with other licensed caregivers; (3) documentation of the grounds for the DNACPR. Our aim was to evaluate adherence to this legislation, explore the grounds for the decision and the attitudes of patients and relatives towards DNACPR orders. Methods We included DNACPR forms issued after admission through the emergency department at Karolinska University Hospital between 1st January and 31st October, 2015. Quantitative analysis evaluated adherence to legislation and qualitative analysis of a random sample of 20% evaluated the grounds for the decision and the attitudes. Results The cohort consisted of 3583 DNACPR forms. In 40% of these it was impossible to consult the patient, and relatives were consulted in 46% of these cases. For competent patients, consultation occurred in 28% and the most common attitude was to wish to refrain from resuscitation. Relatives were consulted in 26% and they mainly agreed with the decision. Grounds for the DNAR decision was most commonly severe chronic comorbidity, malignancy or multimorbidity with or without an acute condition. All requirements of the legislation were fulfilled in 10% of the cases. Conclusion In 90% of the cases physicians failed to fulfil all requirements in the Swedish legislation regarding DNAR orders. The decision was mostly based on chronic, severe comorbidity or multimorbidity.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Djärv, ThereseKarolinska Institutet (author)
  • Rakovic, KatarinaFunction of Perioperative Medicine and Intensive Care Solna, Karolinska University Hospital, Stockholm, Sweden (author)
  • Boström, EmilEmergency and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden (author)
  • Forsberg, SuneKarolinska Institutet (author)
  • Holzmann, Martin J.Department of Medicine Solna, Karolinska Institutet Emergency and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden (author)
  • Herlitz, Johan,1949-Gothenburg University,Göteborgs universitet,Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,PreHospen,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xherjo (author)
  • Göransson, KatarinaKarolinska Institutet (author)
  • Karolinska InstitutetFunction of Perioperative Medicine and Intensive Care Solna, Karolinska University Hospital, Stockholm, Sweden (creator_code:org_t)

Related titles

  • In:Resuscitation Plus: Elsevier BV62666-5204

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