Today as part of a research project, I distributed the following questionnaire to paramedics at our annual paramedic skills session.
***
Paramedic DNR Study
Please Fill in or Circle Your Answers
How many years have you been a paramedic? ____
How old are you now? ____
To the best of your recollection how many times have you attempted resuscitation in the field? _______
Are you aware of your current protocols for withholding resuscitation? Yes No
Do you feel they are adequate? Yes No
Have you ever resuscitated a cardiac arrest against a family’s wishes due to lack of documentation? Yes No
If so, were you bothered by that action?
No Somewhat Yes Greatly
You are called to respond to a 90-year-old male who has stopped breathing. On arrival at the single family home, the patient’s son says his father had terminal cancer and did not wish to be revived. He says he called 911 only to alert police to his father’s passing, not to request medical assistance and attempts at resuscitation. On questioning, he says his father is a DNR, but the papers are locked in a safe. His wife, who has the combination, is on her way and should arrive in ten to twenty minutes. The patient is pulseless and apneic. What do you do?
a. Immediately begin CPR and initiate ACLS.
b. Begin CPR, but hold off on initiation of ACLS while you contact medical control for permission to cease resuscitation.
c. Begin CPR, but hold off on initiation of ACLS pending arrival of wife and her ability to produce DNR papers from the safe.
d. Hold off on CPR while you contact medical control for permission not to implement resuscitation.
e. Do not implement CPR. Instead presume the patient dead.
Do you favor changing the regulations to enable paramedics to honor a family’s verbal request not to initiate CPR if the patient has a terminal condition (cancer, end-stage renal failure, etc.)? Yes No
This is a study about paramedic attitudes toward DNR issues. By completing the questionnaire you consent to having your responses published. Your answers will be kept anonymous. No punitive action will ever arise from your answers.
***
I recieved 96 completed questionnaires. I'll publish preliminary results tomorrow with comment.
