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Out-of-Hospital Resuscitation: Have We Gone Too Far?

Published online by Cambridge University Press:  28 June 2012

Corita Grudzen
Corita Grudzen*
Affiliation:
Robert Wood Johnson Critical Scholar, University of California-Los Angeles, School of Medicine, Los Angeles, California, USA
*
Corita Grudzen, MD University of California-Los Angeles School of Medicine, 911 Broxton Avenue Los Angeles, California 90024, USA E-mail: cgrudzen@mednet.ucla.edu
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Abstract

Americans are living longer and are more likely to be chronically or terminally ill at the time of death. Although surveys indicate that most people prefer to die at home, the majority of people in the United States die in acute care hospitals. Each year, approximately 400,000 persons suffer sudden cardiac arrest in the US, the majority occurring in the out-of-hospital setting. Mortality rates are high and reach almost 100% when prehospital care has failed to restore spontaneous circulation. Nonetheless, patients who receive little benefit or may wish to forgo life-sustaining treatment often are resuscitated. Risk versus harm of resuscitation efforts can be differentiated by various factors, including cardiac rhythm. Emergency medical services policy regarding resuscitation should consider its utility in various clinical scenarios. Patients, family members, emergency medical providers, and physicians all are important stakeholders to consider in decisions about out-of-hospital cardiac arrest. Ideally, future policy will place greater emphasis on patient preferences and quality of life by including all of these viewpoints.

Keywords

do-not-resuscitateemergency medical serviceethicslife-sustaining treatmentout-of-hospital resuscitation
Type
Comprehensive Review
Information
Prehospital and Disaster Medicine , Volume 21 , Issue 6 , December 2006 , pp. 445 - 450
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2006

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