To determine the factors considered most important by emergency physicians when deciding to institute or withhold resuscitation in a hypothetical patient with a life‐threatening illness.
A self‐administered questionnaire containing a clinical scenario was posted to all Victorian emergency physicians in April 1997. Respondents were asked to decide between intubation and no active treatment, to rate the importance of various factors in making this decision and to rate the likelihood of altering the decision given hypothetical changes in the scenario.
The response rate was 67% (46/69). Of those choosing intubation (89%), most would have changed the decision if the patient had dementia, was permanently bed‐bound or was totally dependent for activities of daily living. Decisions were most influenced by reversibility of the illness, the patient’s functional state and the perceived quality of life.
Emergency physicians consider many factors when deciding whether or not to actively resuscitate patients. Further study of the decision making process is recommended.
Biegler P, Thomson G. Factors influencing resuscitation decisions in the emergency department. Emergency Medicine Australasia 1998; 10: 218-25