Never been asked to do this, but it sounds eminently sensible to me. There's
far too much pointless attempted resuscitation these days. The problem is,
however, that it's the ambulance service who commence resuscitation; they're
the ones who should really be aware of the advance directive if it is to be
effective.
Put it this way, if the patient doesn't require prehospital resuscitation,
then it's likely you will have time to establish the patient's wishes before
resuscitation is required in the ED. Conversely, if the patient does require
prehospital resuscitation, then logging the advance directive in the ED will
not do much good in terms of avoiding the unwanted resuscitation.
But nevertheless the principle seems quite reasonable, and there shouldn't
be a legal problem with this. (These days the commonest form I fill out in
resus, next to CT head, is a DNAR form!) And it shouldn't really matter that
you can't guarantee that resus won't be attempted; at least by logging the
directive you will greatly reduce the chances of resus being attempted - or
being continued - so it's better than doing nothing about it at all.
AF
----- Original Message -----
From: "Brown, Ruth" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, May 05, 2007 3:41 PM
Subject: Advance directives
Does anyone on the list accept advance directives from patients "in
advance" - ie scan them onto the system and flag them as a special case
prior to their arrival? we have been asked if we can do it, and I am
concerned that to accept the advance directive and undertake to scan it in
suggests that we will be able to guarantee we won't start resus and I am not
sure that is possible
what do others think?
Ruth
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