Brims Fraser J H, Kilminster Shaun, Thomas Lynn M
Respiratory Department, Queen Alexandra Hospital, Portsmouth.
Clin Med (Lond). 2009 Feb;9(1):16-20. doi: 10.7861/clinmedicine.9-1-16.
The decision to perform cardiopulmonary resuscitation (CPR) remains one of the most important and difficult decisions a physician must make. This study examined differences in CPR decision making among senior hospital clinicians. A questionnaire was sent out to consultants and specialist registrars in general medicine, elderly care and intensive care in a large UK district general hospital, with anonymous returns. Short clinical scenarios were presented, and participants stated their CPR decision and their confidence level. In total, 86 questionnaires were sent out and 54 replies (63%) were received. There were significant differences between specialties in making the decision to perform CPR and the confidence in doing so, with three cases producing polarised results within the specialties, despite equal confidence in the decision. There is lack of consensus with the CPR decisions made between specialties and within them. Formal training in recognition of futility should be encouraged for all clinicians.
决定是否进行心肺复苏(CPR)仍然是医生必须做出的最重要且最困难的决定之一。本研究调查了资深医院临床医生在心肺复苏决策方面的差异。向英国一家大型地区综合医院的普通内科、老年护理和重症监护科室的顾问医生和专科住院医生发放了问卷,并采用匿名方式回收。问卷给出了简短的临床场景,参与者需表明他们的心肺复苏决策及自信程度。总共发放了86份问卷,收到54份回复(63%)。在决定是否进行心肺复苏以及对此的信心方面,各专科之间存在显著差异,尽管对决策的信心相同,但有三个案例在专科内部产生了两极分化的结果。各专科之间以及专科内部在心肺复苏决策上缺乏共识。应鼓励对所有临床医生进行关于认识治疗无效性的正规培训。