PMID: 25793250Mar 21, 2015Paper

Researchers offer up a mnemonic tool to guide clinicians who must assess decision-making capacity in patients during emergency situations

ED Management : the Monthly Update on Emergency Department Management

Abstract

Clinicians from Johns Hopkins University School of Medicine have developed a mnemonic-driven tool to help clinicians quickly assess whether patients have decision-making capacity during emergency situations. The approach uses the mnemonic "CURVES" to guide physicians to first consider whether patients have decision-making capacity, and then to determine whether treatment can be commenced-without informed consent. The first four letters of the mnemonic "CURVES'" stand for: choose and' communicate, understanding, reason, and value. The authors rote that these four qualities/abilities need to be present to establish decision-making capacity. The last two letters of the pneumonic stand for emergency and surrogate, prompting physicians to consider whether the patient is at immninent risk and whether there is a surrogate decision-maker available. The authors note that while the issues represented by the CURVES pneumonic should be very familiar to clinicians, effective use of the tool requires training and practice.

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