Davies K N, King D, Silas J H
Clatterbridge Hospital, Wirral.
J R Coll Physicians Lond. 1993 Apr;27(2):127-30.
Cardiopulmonary resuscitation for the elderly has long been a contentious issue. We have established by means of a postal survey the attitudes of 300 consultant geriatricians, 300 consultant physicians and 249 registered nurses to cardiopulmonary resuscitation. We also audited 400 case notes to document current practice in departments of general medicine and medicine for the elderly. No formal resuscitation policies were in operation. Geriatricians were more likely than physicians to make a positive resuscitation decision (p < 0.001), and involve nursing staff in the decision-making (p < 0.001). All professional groups felt age was unimportant in deciding on resuscitation, while the patients' prognoses and their wishes were most important. Case note audit revealed that geriatricians were better at documenting resuscitation decisions. Inappropriate resuscitation of patients is unacceptable. Each department or hospital ought to have agreed guidelines for cardiopulmonary resuscitation.
老年人的心肺复苏长期以来一直是一个有争议的问题。我们通过邮政调查确定了300名老年病顾问医生、300名内科顾问医生和249名注册护士对心肺复苏的态度。我们还审核了400份病历,以记录普通内科和老年医学科的当前做法。当时没有正式的复苏政策在实施。老年病医生比内科医生更有可能做出积极的复苏决定(p<0.001),并且让护理人员参与决策(p<0.001)。所有专业群体都认为年龄在决定是否进行复苏时并不重要,而患者的预后和意愿才是最重要的。病历审核显示,老年病医生在记录复苏决定方面做得更好。对患者进行不适当的复苏是不可接受的。每个科室或医院都应该有一致的心肺复苏指南。