What should we say when discussing "code status" and life support with a patient? A Delphi analysis

Journal of Palliative Medicine
James Downar, Laura Hawryluck

Abstract

Patients and clinicians often find it difficult to discuss wishes regarding cardiopulmonary resuscitation (CPR) or "code status." Some authors have published effective communication styles, but there are currently no published guidelines for the content of a discussion about resuscitation or goals of care. We identified a group of physicians with expertise in end-of-life care and communication, and used the Delphi method to develop a series of consensus statements about the ideal content of a discussion of CPR and goals of care. Twelve physicians agreed to participate in the study, generating nine consensus statements. These statements addressed the following topics: timing the discussion; framing the discussion in terms of "goals of care"; distinguishing between life-sustaining therapy (LST) and CPR; describing a cardiac arrest, LST, CPR, and palliative care; describing what happens after a cardiac arrest; how to modify the discussion to respect a patient's medical condition or beliefs; offering a prognosis; making a recommendation; and the importance of trust and rapport. There was consensus for each statement after the second Delphi round. Physicians with expertise in end-of-life care and communication were able to develop c...Continue Reading

References

Jun 1, 1992·Birth·H Statham, J Dimavicius
Apr 22, 1992·JAMA : the Journal of the American Medical Association·E J Emanuel, L L Emanuel
Aug 5, 1995·BMJ : British Medical Journal·J Jones, D Hunter
Apr 6, 1994·JAMA : the Journal of the American Medical Association·M L Campbell
Apr 1, 1993·The Journal of Family Practice·E J Volpintesta
Apr 5, 2002·The New England Journal of Medicine·Terri R FriedHeather Allore
Aug 13, 2002·BMC Medical Ethics·Laura A HawryluckPeter A Singer
Jan 16, 2003·Intensive Care Medicine·Daren K HeylandChristopher J O'Callaghan
Mar 5, 2003·Annals of Internal Medicine·Anthony L BackTimothy E Quill
Sep 27, 2003·BMJ : British Medical Journal·John Paling
Dec 30, 2004·Palliative Medicine·Mohamed Y Rady, Daniel J Johnson
Aug 26, 2006·Critical Care Medicine·Judith E NelsonUNKNOWN Critical Care Peer Workgroup of the Promoting Excellence in End-of-Life Care Project
Feb 3, 2007·The New England Journal of Medicine·Alexandre LautretteElie Azoulay
Mar 14, 2007·Archives of Internal Medicine·Douglas B WhiteJ Randall Curtis
Nov 6, 2007·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Robert SibbaldLaura Hawryluck
Apr 2, 2008·Critical Care Medicine·Bradford J GlavanJ Randall Curtis
Apr 24, 2008·Critical Care Medicine·Robert D TruogUNKNOWN American Academy of Critical Care Medicine
Oct 10, 2008·Chest·J Randall Curtis, Douglas B White
Jun 6, 2009·American Journal of Respiratory and Critical Care Medicine·Douglas B WhiteBernard Lo

❮ Previous
Next ❯

Citations

Jan 12, 2011·Journal of General Internal Medicine·James DownarLaura Hawryluck
Apr 14, 2012·Emergency Medicine International·Roberto ForeroKen Hillman
Feb 15, 2014·Journal of General Internal Medicine·Rashmi K SharmaKenzie A Cameron
Apr 1, 2014·Journal of Pain and Symptom Management·Andrew ThurstonRashmi K Sharma
Apr 10, 2016·Intensive Care Medicine·James DownarLisa Kenny
Mar 9, 2021·Health Expectations : an International Journal of Public Participation in Health Care and Health Policy·Anca-Cristina SterieEve Rubli Truchard

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine
Nelson NicolasoraConstantine A Manthous
Journal of Palliative Medicine
Eytan SzmuilowiczDiane B Wayne
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Charles F von Gunten
Critical Care Medicine
Jeffrey P BurnsRobert D Truog
© 2022 Meta ULC. All rights reserved