To resuscitate or not?

To resuscitate or not to resuscitate.

You pull up on scene of a rollover to transport a trauma victim or you are standing in the ED waiting for the ambulance to bring in the trauma victim. One of the first things you might be thinking is, “I need two large bore IVs with warmed fluids running wide open!” However, current evidence-based practice is trending to very judicious use of IV fluids. Where it was once thought that more fluid...

Deciding not to resuscitate in Dutch hospitals.

The use of do not resuscitate (DNR) orders in Dutch hospitals was studied as part of a nationwide study on medical decisions concerning the end of life. DNR decisions are made in 6 per cent of all admissions, and 61 per cent of all in-hospital deaths were preceded by a DNR decision. We found that in only 14 per cent of the cases had the patients been involved in the DNR decision (32 per cent of...

Impediments to writing do-not-resuscitate orders.

BACKGROUND Physicians are frequently unaware of their patients' desires regarding end-of-life care. Consequently, opportunities to implement do-not-resuscitate (DNR) orders are often missed. OBJECTIVE To determine the reasons attending physicians do not write DNR orders when patients face increased mortality. METHODS Over 4 months, the medical records of all inpatients on the General Medici...

Do NOT Resuscitate.

L i ke many health care prov iders , I’ve spent time contemplating the circumstances of my own death. Where will I be when I die? Who will be present? What will the doctors be doing—or will there even be any doctors in the room? The more involved we are with the dying, the more these kinds of thoughts tend to push into our consciousness. I’ve seen people die in all sorts of places and under wil...

Folic Acid Supplementation: to Advise or not to Advise?