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KMID : 0385919930040020108
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Journal of the Korean Society of Emergency Medicine
1993 Volume.4 No. 2 p.108 ~ p.115
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Do-Not-Resuscitate Decisions in the Emergency Department
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김영식
황성오/이부수/안무업/임경수/강성준
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Abstract
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Do-not-resuscitate (DNR) decision in certain patients is a important part of patient management. The use of DNR order has been widely recognized in hospitalized patients, but there has been little discussion of the use of DNR order in emergency
department. DNR decision in emergency department is difficult because there is no previous contact between physician and patient.
To identify the medical reasons of the DNR decision and the process of the DNR in the emergency department, 293 DNR patients in emergency department during 1 year and 36 physicians having experienced DNR decision were studied.
Reasons for DNR are irreversible states from brain damage or acute illness (63%), chronic irreversible illness (15%), prolonged cardiac arrest over 30 minutes (16%), physical injurics including decapitation (1%) and family's hope (5%). Alomost
DNR
(72%)
were decided by physicians. 72% of DNR decision were not doct nented. Cardiopulmonary resuscitation was attempted before DNR decision in 38% of the patients and 17% of CPR attempts were unnecessary. Almost physician (88%) replied that physician
should
discuss resuscitation with family and process of DNR decision should be documented.
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KEYWORD
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