Cpr Evaluation Essay

Though ethics committees have been helpful, scores of physician-patient disagreements end up in the U.S. court system with inconsistent results. The states adopted individual “statutes regulating DNR orders and their provisions vary in analysis throughout the U.S.” (Bishop, Brothers, Perry & Ahmad, 2010). One ethical dilemma that is constant in emergency rooms, the intensive care unit and terminally ill persons is a futility of treatment. In the case of CPR/DNR, New York State wanted to enact a law that describes the decisive responsibilities of the patient, and the family or surrogate, and physician. “In April 2003, the New-York Attorney General asserted that the DNR law would require a physician to obtain a consent of the patient’s health care surrogate before entering a DNR order, even when the physician

Secondly, the patient should be capable of making and communicating health care decisions for him or herself. Thirdly, the patient must be diagnosed with a terminal illness that will lead to death within six months.  Interested patients must also provide the request for termination in writing to the physician. In addition, physicians are expected to inform patients to alternative means of care including hospice care and other medications. Only after precautions evaluation, the laws then permit patients to make the ultimate life ending decision.

Topic 1). Let's begin with the basics... What is CPR? It is a live saving procedure done by performing chest compressions to pump the heart in order for it to circulate blood and deliver oxygen to the brain. Who knows what CPR stands for? (pause) CPR stands for cardiopulmonary resuscitation.

Have you ever thought about what you would do if a family member suddenly stopped breathing? Imagine that you grow up in a small town, the population is 700 people, and one morning you wake up and everyone in the town is dead. On any given day 670 people die of sudden cardiac arrest. Could it be a loved one, someone you care deeply for, or just a complete stranger? The chances are that someone in your family is going to die of sudden cardiac arrest in your lifetime. On average it takes an ambulance no less than seven minutes to reach someone in need, therefore, every adult should know how to administer CPR.

A legal requirement of end of life care is that the wishes of the individual, including whether CPR should be attempted, as well as their wishes how they are cared for after death are properly documented. This means that their rights and wishes even after death are respected.

A legal requirement of end of life care is that the wishes of the individual, including whether CPR should be attempted, as well as their wishes how they are cared for after death are

Medical regulators in every province have issued detailed guidelines that doctors must follow to help suffering patients end their lives and most of these guidelines impose safeguards. It is required that at least two doctors must agree that a patient meets the eligibility

The current health situation should be explained in a non-technical way so the patient (if possible) family, and or valid surrogate can understand every aspect. The physician should also help them understand when there is no hope for recovery. Most often the organs are no longer functioning, or there is little to no brain activity; at this point suffering potentially outweighs the probability of recovery. Medical teams most often realize that the focus should be on comfort, rather than extending a dying life. This decision comes with a great deal of uncertainty, and will always be hard, no matter what age of the patient, or the circumstances. Kathryn Kosh, MD explains that, “Ready access to advanced modern technology has changed death from an event to a process… Defying death requires payment [in the form of] pain and discomfort or in an unacceptable decline in the quality of life.” Often times physicians will not prescribe treatment in the first place knowing that this option will not benefit the patient, prolong suffering; and will likely end in termination anyway. Therefore, allowing the nature of the illness or injury to take its own course of action. Another point of interest regarding this topic is that medical teams realize in most cases, that providing an ethical and dignified death can be just as rewarding as administering aggressive measures to save a

WEEK 5 PICO(T) QUESTION 1Good Afternoon Class and Dr. Stephenson,In and out of the hospital high quality cardiopulmonary resuscitation (CPR) is crucial to survival of victims of cardiac arrest. This research topic will focus on implementation of in hospital chest compressions in CPR. It will be based on a comparison of the efficacy of manual compressions and automated chest compressions in relation to survival outcomes. The potential attributes and short comings related to manual and automated chest compression will be reviewed. Intensive care unit (ICU) nurses have to be prepared to implement CPR during a cardiac arrest code. In consideration that patients in the ICU are often only marginally stable it is important that ICU nurses are familiar with their patient’s recent and past medical histories.

John was a 76 year old gentleman returning to an orthopaedic ward following a total hip replacement under general anaesthetic. The agreed care plan was to regularly monitor John’s vital signs over the next several hours in accordance with local hospital resuscitation trust policy (2012) and the National Institute

With an increasing aging population and growing numbers of individuals with chronic conditions, it is important for individuals to prepare for end-of-life care. An Advance Directive is a defined as a “legal document that provides data to critical care staff about patients’ wishes, especially when critical illness decreases decision-making ability” (McAdam, Stotts, Padilla, and Puntillo, 2005). An Advance Directive also allows for better communication between the patient and doctor, and preserves the autonomy of patients. It may also alleviate one’s family from any possible burden of uncertainty of one’s wishes. It provides guidance, which may avert arguments with family members concerning treatment choices (Cedars Sinai, 2015). The Patient

Some people in the public, and especially RNs and nursing students, know exactly what a DNR is. They know that this means once a person experiences a cardiac and/or respiratory arrest, they are not to be resuscitated. In a policy from IU Health North Hospital (2016), the following treatments are to be withheld in the case of a respiratory and/or cardiac arrest when the patient has a signed DNR: chest compressions, start of ventilation support, endotracheal intubation, electrical countershock, cardiac pacing externally, and/or bolus administration containing antiarrhythmic, vasopressors, or inotropes. There is an exceptions section to the policy that states that “DNR orders are generally suspended in anesthetizing locations” (IU Health North Hospital, 2016, p. 4). It is noted that any existing directives need to be discussed with the patient when possible. It is important to view all aspects to this ethical issue to be able to see the entire picture of it. This includes looking at what is currently done, the opinions of patients and physicians, along with looking at policies from the American Society of Anesthesiologists along with the American College of Surgeons.

| Lesson Outline: Allocated teacher-NExplaining legal requirements : Duty of care: A duty of care is implied when the person who is requiring your assistance is in your workplace. E.g. patient, co-worker or visitor. Consent of an unresponsive patient is assumed in an emergency situation. (Crouchman, 2009; Milne & Mellman-Jones, 2010).Cultural awareness/sensitivity: We need to mindful of varying cultures when assisting patients, as different cultures prefer to be unexposed which is necessary when defibrillation is required. Eg, Muslims (Hattersley & Keogh, 2009). Confidentiality: Following an emergency situation it is vital to refrain from speaking to others outside the workplace about the patient to ensure the patient’s privacy and dignity. Think about how you would feel if you where in the patient’s situation. (Maeder, Martin-Sanchez, Croll, & Ambrosoli, 2012)?Limitations: Remember that once you start you can’t stop until you’re physically unable to or help arrivesDebriefing: Participating in the debriefing process is vital due to the enormity of the situation, enabling the nurse to express

An identified concern with the use of E-CPR in prolonged resuscitation is the risk that survivors may suffer severe neurological deficits which will lead to an extended hospital stay in the intensive care unit (ICU) (Stub et al., 2015). Siao et al., (2015) used the Glasgow-Pittsburgh cerebral performance category (CPC) scale to evaluate neurological outcomes in their study. The study found at discharge, a good neurological outcome rate of 40% (n=8/20) in the E-CPR group compared to only 7.5% (n=3/40) in the C-CPR group, again favouring E-CPR over C-CPR. A major limitation of this study however, is that it is was a retrospective observational study rather than a randomized controlled trial, the authors did however rightfully acknowledge that

A Do not resuscitate (DNR) order is a legal document written by a licensed physician, which is developed in consultation with the patient, surrogate decision maker, and attending physician. This document indicates whether the patient will receive resuscitative care, cardiopulmonary resuscitation (CPR), or advanced medical directives, in the setting of cardiac and/or respiratory arrest. A DNR can also be referred as a no code when identifying a patient’s resuscitation status. If a patient has an existing DNR it allows the resuscitation team, taking care of the patient, to either withhold or stop any resuscitation measures, and therefore respect the patient’s wishes. Historically, DNR orders did not become active in the care of patients until 1974, when it was identified that patients who received CPR, and survived, had significant morbidities (Braddock & Derbenwick-Clark, 2014). Braddock and Derbenwick-Clark further noted, the American Heart Association (AHA) recommended that physicians, in consultation with the patient, family, and or surrogate, place on the patients chart when CPR was not indicated. This documentation is now what we refer to as the DNR order and has become the standard to allow autonomous respect for patients, and their families, to make informed medical decisions. Therefore, the purpose of this paper is to discuss the legal aspects, ethical issues, and the application surrounding the DNR order.