ArticleInternational journal of emergency medicine2024
Consideration of advance directives by emergency physicians in patients with cardiac arrest: a clinical vignettes-based qualitative study.
Article in International journal of emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency medical services (EMS) must incorporate the patient's physiologic state and end-of-life wishes when determining whether to initiate and/or continue cardiopulmonary resuscitation (CPR). This study aims to describe and analyze the use of advance directives (ADs) in CPR by emergency physicians (EPs).
methodsA qualitative approach using semi-directed interviews was conducted. EPs were confronted with three fictitious clinical situations where they would have to take under their care a young patient with no previous history or treatment, presenting with a cardiac arrest and a do not attempt CPR (DNACPR) order.
resultsTwenty EPs, 10 men and 10 women (mean age 39.7 ± SD 11,21), were included either for individual interviews or a focus group. Without the AD, EPs all declared that they would have started CPR. With the AD, 6 physicians accepted ADs and did nothing, 5 physicians performed a time-limited trial to allow time for collegial discussion, and 9 physicians rejected ADs alone and resuscitated. Inductive analysis of the verbatims identified 4 themes (reflection, assessment of the medical situation, determining the validity of ADs, cognitive dissonance) and the opposability of ADs to medical decisions was the point of divergence within the focus group.
conclusionThis difference seems to be explained by different thought processes, notably concerning two steps: determining the validity of ADs, and the cognitive dissonance induced by the situation. EPs seem to respect ADs in cardiac arrest when determining the validity of ADs can be quick and the physician understands why the AD was written.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.