Survey of hospital practitioners: common understanding of cardiopulmonary resuscitation definition and outcomes.

Autor: Berry-Kilgour NAH; Te Whatu Ora, Nelson Marlborough, Nelson, New Zealand., Paulin JR; Te Whatu Ora, Wellington, New Zealand., Psirides A; Te Whatu Ora, Wellington, New Zealand., Pegg TJ; Te Whatu Ora, Nelson Marlborough, Nelson, New Zealand.
Jazyk: angličtina
Zdroj: Internal medicine journal [Intern Med J] 2023 Nov; Vol. 53 (11), pp. 2050-2056. Date of Electronic Publication: 2023 Mar 31.
DOI: 10.1111/imj.16046
Abstrakt: Background: Cardiopulmonary resuscitation (CPR) is internationally defined as chest compressions and rescue breaths, and is a subset of resuscitation. First used for out-of-hospital cardiac arrest, CPR is now frequently used for in-hospital cardiac arrest (IHCA) with different causes and outcomes.
Aims: This paper aims to describe clinical understanding of the role of in-hospital CPR and perceived outcomes for IHCA.
Methods: An online survey of a secondary care staff involved in resuscitation was conducted, focussing on definitions of CPR, features of do-not-attempt-CPR conversations with patients and clinical case scenarios. Data were analysed using a simple descriptive approach.
Results: Of 652 responses, 500 were complete and used for analysis. Two hundred eleven respondents were senior medical staff covering acute medical disciplines. Ninety-one percent of respondents agreed or strongly agreed that defibrillation is part of CPR, and 96% believed CPR for IHCA included defibrillation. Responses to clinical scenarios were dissonant, with nearly half of respondents demonstrating a pattern of underestimating survival and subsequently showing a desire to offer CPR in similar scenarios with poor outcomes. This was unaffected by seniority and level of resuscitation training.
Conclusions: The common use of CPR in hospital reflects the broader definition of resuscitation. Recapturing the CPR definition for clinicians and patients as only chest compressions and rescue breaths may allow clinicians to better discuss individualised resuscitation care to aide meaningful shared decision-making around patient deterioration. This may involve reframing current in-hospital algorithms and uncoupling CPR from wider resuscitative measures.
(© 2023 Royal Australasian College of Physicians.)
Databáze: MEDLINE
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