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Do-not-resuscitate orders among trauma patients.
Catherine A Marco1, Scarlett Michael1, Jamie Bleyer1
1Department of Emergency Medicine, 3525 Southern Blvd, Kettering, OH 45429.
Most do-not-resuscitate (DNR) orders among trauma patients were initiated during hospitalization. For deceased patients with DNR orders, cardiopulmonary resuscitation (CPR) was rarely performed.
Area of Science:
- Trauma surgery
- Critical care medicine
- Geriatric medicine
Background:
- Do-not-resuscitate (DNR) orders are crucial for end-of-life care communication.
- Previous research indicates varied prevalence of DNR orders in hospitalized trauma patients.
Purpose of the Study:
- To determine the prevalence and types of DNR orders in trauma patients.
- To explore associations between DNR orders and injury severity, length of stay, and CPR use.
Main Methods:
- Retrospective review of medical records for 263 trauma patients with DNR orders.
- Data collected from Miami Valley Hospital in 2014.
Main Results:
- 8% of 3394 trauma patients had a DNR order; most were instituted during hospitalization (67%).
- Falls (81.4%) and motor vehicle collisions (6.1%) were common injury mechanisms.
- Among deceased patients (38%), only 14% received CPR.
Conclusions:
- The majority of DNR orders in trauma patients are established during their hospital stay.
- CPR was infrequently administered to deceased trauma patients with existing DNR orders.
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