ED Manag. 2015 Mar;27(3):32-4.
Clinicians from Johns Hopkins University School of Medicine have developed a mnemonic-driven tool to help clinicians quickly assess whether patients have decision-making capacity during emergency situations. The approach uses the mnemonic "CURVES" to guide physicians to first consider whether patients have decision-making capacity, and then to determine whether treatment can be commenced-without informed consent. The first four letters of the mnemonic "CURVES'" stand for: choose and' communicate, understanding, reason, and value. The authors rote that these four qualities/abilities need to be present to establish decision-making capacity. The last two letters of the pneumonic stand for emergency and surrogate, prompting physicians to consider whether the patient is at immninent risk and whether there is a surrogate decision-maker available. The authors note that while the issues represented by the CURVES pneumonic should be very familiar to clinicians, effective use of the tool requires training and practice.
约翰·霍普金斯大学医学院的临床医生开发了一种由助记符驱动的工具,以帮助临床医生在紧急情况下快速评估患者是否具备决策能力。该方法使用助记符“CURVES”来指导医生首先考虑患者是否具备决策能力,然后确定在未经知情同意的情况下是否可以开始治疗。助记符“CURVES”的前四个字母代表:选择和沟通、理解、推理和价值观。作者指出,要确立决策能力,必须具备这四种品质/能力。该助记符的最后两个字母代表紧急情况和替代决策者,促使医生考虑患者是否面临紧迫风险以及是否有替代决策者可用。作者指出,虽然CURVES助记符所代表的问题临床医生应该非常熟悉,但有效使用该工具需要培训和实践。