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Cardiopulmonary Resuscitation I: Adult01:21

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Cardiopulmonary resuscitation, or CPR, is a life-saving emergency procedure performed when a person's heart has stopped beating or they are no longer breathing. The foundation of CPR is Basic Life Support (BLS), which focuses on the early recognition of cardiac arrest, the immediate start of high-quality chest compressions, and the timely use of an automated external defibrillator (AED).Assessing Responsiveness and Checking the Carotid PulseWhen approaching an unresponsive person, first ensure...
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A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique
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Adult Perianesthesia Do Not Resuscitate Orders: A Systematic Review.

Joshua Hardin, Barbara Forshier

    Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses
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    PubMed
    Summary

    It is unethical to automatically rescind Do Not Resuscitate (DNR) orders during anesthesia. Patients can retain or modify DNR orders, with consensus supporting reconsideration before anesthesia.

    Keywords:
    DNRanesthesiacardiopulmonary resuscitationdo not resuscitateethics

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    Area of Science:

    • Medical Ethics
    • Anesthesiology
    • Health Policy

    Background:

    • Do Not Resuscitate (DNR) orders are critical patient directives.
    • Routine rescission of DNR orders during anesthesia is a debated practice.

    Purpose of the Study:

    • Assess the routine rescission of DNR orders during anesthesia.
    • Determine consensus on retaining DNR orders in medical literature.
    • Explore current clinical practices regarding DNR orders in perianesthesia.

    Main Methods:

    • Systematic review adhering to PRISMA guidelines.
    • Searched CINAHL and PubMed databases in June 2018.
    • Included 49 articles after screening 91 pooled articles.

    Main Results:

    • 49 articles analyzed, with 16 identified as formative.
    • Evidence suggests automatic rescission of DNR orders is unethical.
    • A consensus exists among professional organizations for DNR reconsideration.

    Conclusions:

    • Patients have the right to maintain or alter DNR orders during anesthesia.
    • Automatic rescission of DNR orders is ethically unacceptable.
    • Policy development is supported by sufficient evidence; reconsideration is the standard of care.