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The Physician Orders for Life-Sustaining Treatment program: Oregon emergency medical technicians' practical
Terri A Schmidt1, Susan E Hickman, Susan W Tolle
1Center for Ethics in Health Care, Oregon Health and Science University, Portland, Oregon 97239, USA. schmidtt@ohsu.edu
Objectives:
To evaluate emergency medical technicians' (EMTs) experiences with the Physician Orders for Life-Sustaining Treatment (POLST) program and learn about attitudes regarding its effectiveness.
Design:
Anonymous survey mailed to a stratified random sample.
Setting:
Tri-County Portland, Oregon, area.
Participants:
A total of 572 Oregon EMT respondents (out of 1,048 surveys) were included in the analysis.
Measurements:
Survey questions about experiences with the POLST form and opinions about POLST.
Results:
Respondents were mostly male (76%) and paramedics (66%). Most respondents (73%) had treated a patient with a POLST, and 74% reported receiving education about POLST. EMTs reported that POLST, when present, changed treatment in 45% of cases. Seventy-five percent of the respondents agreed that the POLST form provides clear instructions about patient preferences, and 93% agreed that the POLST form is useful in determining which treatments to provide when the patient is in cardiopulmonary arrest. Fewer (63%) agreed that the form is useful in determining treatments when the patient has a pulse and is breathing.
Conclusion:
Most respondents have experience with the POLST program. EMTs find the POLST form useful and often use it to change treatment decisions for patients.
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