Limiting treatment in pre‐hospital care: A prospective, observational multicentre study

• DOI: 10.1111/aas.13649
• Publication Date: 2020-06-10T19:17:04Z
• Authors: Heidi Kangasniemi; Piritta Setälä; Anna Olkinuora; Heini Huhtala; Joonas Tirkkonen; Antti Kämäräinen; Ilkka Virkkunen; Arvi Yli‐Hankala; Esa Jämsen; Sanna Hoppu
• Keywords: Limiting

Background Data are scarce on the withdrawal of life‐sustaining therapies and limitation care orders (LCOs) during physician‐staffed Helicopter Emergency Medical Service (HEMS) missions. We investigated LCOs quality information available when physicians made treatment decisions in pre‐hospital care. Methods A prospective, nationwide, multicentre study including all Finnish HEMS bases a 6‐month period. All missions where patient had pre‐existing and/or new LCO were included. Results There 335 with LCOs, which represented 5.7% (n = 5895). 181 total 170 issued. Usually, was do not attempt cardiopulmonary resuscitation order only 133, 74%). The most frequent ‘termination resuscitation’ 61, 36%), while ‘no intensive care’ combined some other almost as common 54, 32%). When issuing for patients who did have any preceding 153), every (49%) case thought that should already an LCO. physician decisions, patients' background from on‐scene paramedics 260 (78%) missions, medical records 67 (20%) Conclusion Making or treating is integral part physicians' work, twentieth mission involving patients. mostly concerned withholding