scholarly journals First Do No Harm in End-of-Life Care: A Comment on the 2015 American Heart Association Guidelines for Post-Resuscitation Care of Cardiopulmonary Arrest

2016 ◽  
Vol 19 (4) ◽  
pp. 349-350
Author(s):  
Mohamed Y. Rady ◽  
Joseph L. Verheijde
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
American Heart Association ◽  
American Heart ◽  
Cardiopulmonary Arrest ◽  
Heart Association ◽  
Life Care ◽  
Do No Harm

2206Prevalence and determinants of complicated grief in bereaved caregivers of patients admitted for cardiovascular diseases

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Shinada ◽  
T Kohno ◽  
K Fukuda ◽  
M Higashitani ◽  
N Kawamatsu ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
End Of Life ◽  
Psychological Health ◽  
End Of Life Care ◽  
Cardiopulmonary Arrest ◽  
Tertiary Care ◽  
Complicated Grief ◽  
Life Care ◽  
Bereaved Family

Abstract Introduction Few studies have examined complicated grief in bereaved caregivers of patients with cardiovascular diseases (CVD), in contrast with studies in caregivers of patients with cancers. We examined the prevalence and determinants of complicated grief among bereaved caregivers of patients with CVD. Methods We conducted a cross-sectional survey using a self-administered questionnaire for bereaved family members of CVD patients who had died in the cardiology departments of 9 tertiary care centers in Japan. We assessed bereaved caregiver grief status using the Brief Grief Questionnaire (BGQ), and its association with their depression (Patient Health Questionnaire-9 [PHQ-9]). Questionnaire also covered following associated factors: bereaved family member and patient characteristics, end-of-life care (Care Evaluation Scale [CES], a scale for assessment of the structure and process of care); and the quality of the deceased patients' death (Good Death Inventory [GDI]). Results A total of 269 bereaved caregivers (mean age, 64±12 years; 35% male) of patients with CVD (heart failure n=155 myocardial infarction n=32, cardiopulmonary arrest n=15, arrhythmia n=8, and others n=59) were enrolled in the study. Overall, 14.1% of the bereaved caregivers had complicated grief (BGQ≥8), 32.3% had subthreshold complicated grief (BGQ=5–7), and 13.3% had depression (PHQ-9≥10). Bereaved caregivers with complicated grief frequently developed depression (58% vs. 6%, p<0.001). Among the bereaved caregivers with complicated grief, the assessment of end-of-life care was worse (CES score: 28 [21–40] vs. 23 [19–39], p=0.04), and the assessment of the deceased patients' quality of death tended to be worse (GDI score: 4.0 [3.0–4.8] vs. 4.3 [3.7–4.9], p=0.05). The cause of admission as well as preferences of the patient and family (e.g., treatment [focusing on extending life vs. relieving discomfort], desire for information, place of end-of-life) were not associated with the prevalence of complicated grief. The prevalence of complicated grief was associated with loss of a spouse, poor psychological health during the deceased patients' admission, and poor preparation for the patient's imminent death (all p<0.05). Bereaved caregivers with complicated grief had experienced more decisional burdens regarding the deceased patients' treatment (55% vs. 25%, p=0.001). Notably, 64% of bereaved caregivers with complicated grief were not treated (i.e., neither routine follow-up by psychiatrists/psychotherapist nor prescription for anti-depressants/tranquilizers). Conclusions The prevalence of complicated grief of bereavement was 14.0%. When subthreshold complicated grief was included, the prevalence of complicated grief increased to include half of the caregivers; therefore, routine screening of the bereaved could be recommended. Clinicians should pay particular attention to bereaved families with high risk factors to identify those at risk for future development of complicated grief.

What enabled mother and twins to survive 18 minutes after maternal cardiopulmonary arrest?

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Ayumi Matsuoka ◽  
Masaaki Tanaka ◽  
Satoshi Dohi ◽  
Hiromasa Sasaki ◽  
Takumi Taniguchi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
American Heart Association ◽  
American Heart ◽  
Cardiopulmonary Arrest ◽  
Heart Association ◽  
Spontaneous Circulation ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Monochorionic Twins

AbstractA woman carrying monochorionic twins underwent sudden cardiopulmonary arrest at 31 weeks of gestation due to spontaneous coronary artery dissection in the hospital. The resuscitation techniques, with her uterus manually displaced to her left, were initiated immediately and maternal spontaneous circulation was resumed 18 min later. A cesarean section was performed 2 h after the revival and the patient was kept hypothermic for 24 h. Finally, full recovery of both mother and twins was achieved. As in this case, the resuscitation techniques for pregnant women recommended by the American Heart Association, and therapeutic hypothermia, might be effective and contribute much to the survival and recovery of patients.

Mayo Registry for Telemetry Efficacy in Arrest Study: An Assessment of the Utility of Telemetry in Predicting Clinical Decompensation

2016 ◽  
Vol 33 (3) ◽  
pp. 166-175 ◽  
Author(s):  
David Snipelisky ◽  
Jordan Ray ◽  
Gautam Matcha ◽  
Archana Roy ◽  
Dana Harris ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Review ◽  
American Heart Association ◽  
American Heart ◽  
Cardiopulmonary Arrest ◽  
Heart Association ◽  
Inpatient Setting ◽  
Icu Patients ◽  
Time Periods

Introduction: Our study assesses the utility of telemetry in identifying decompensation in patients with documented cardiopulmonary arrest. Methods: A retrospective review of inpatients who experienced a cardiopulmonary arrest from May 1, 2008, until June 30, 2014, was performed. Telemetry records 24 hours prior to and immediately preceding cardiopulmonary arrest were reviewed. Patient subanalyses based on clinical demographics were made as well as analyses of survival comparing patients with identifiable rhythm changes in telemetry to those without. Results: Of 242 patients included in the study, 75 (31.0%) and 110 (45.5%) experienced telemetry changes at the 24-hour and immediately preceding time periods, respectively. Of the telemetry changes, the majority were classified as nonmalignant (n = 50, 66.7% and n = 66, 55.5% at 24 hours prior and immediately preceding, respectively). There was no difference in telemetry changes between intensive care unit (ICU) and non-ICU patients and among patients stratified according to the American Heart Association telemetry indications. There was no difference in survival when comparing patients with telemetry changes immediately preceding and at 24 hours prior to an event (n = 30, 27.3% and n = 15, 20.0%) to those without telemetry changes during the same periods (n = 27, 20.5% and n = 42, 25.2%; P = .22 and .39). Conclusion: Telemetry has limited utility in predicting clinical decompensation in the inpatient setting.

scholarly journals First do no harm: changing culture surrounding ceilings of treatment in end-of-life care

2017 ◽  
Vol 17 (Suppl 3) ◽  
pp. s29-s29
Author(s):  
S McNeill ◽  
E Toner ◽  
S Caskey ◽  
AM Marley ◽  
S Guy ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Do No Harm

scholarly journals O conhecimento sobre parada cardiorrespiratória dos enfermeiros que atuam na atenção básica

2012 ◽  
Vol 2 (4) ◽  
pp. 16
Author(s):  
Simone De Lima Tosi Amador ◽  
Kelly Cristina Pinheiro Costa Silva ◽  
Dayanne De Lima Cunha ◽  
Yara Cristina Peres Pissinatti ◽  
Verônica Aparecida dos Santos
Keyword(s):  
American Heart Association ◽  
American Heart ◽  
Cardiopulmonary Arrest ◽  
Family Health ◽  
Heart Association ◽  
Cardiorespiratory Arrest ◽  
Basic Health ◽  
Emergency Situations ◽  
Family Health Program ◽  
La Red

Desenvolveu-se um estudo, transversal, com o objetivo de identificar o conhecimento dos enfermeiros da rede básica, no atendimento a parada cardiorrespiratória. Foram entrevistados 24 enfermeiros da rede básica de saúde do município de Suzano. Situações de emergência, como a parada cardiorrespiratória, requerem habilidades e medidas iniciais que são primordiais no atendimento adequado, porém, foi possível identificar que os enfermeiros que atuam em Unidade Básica de Saúde/Programa de Saúde da Família, não estão atualizados perante a nova preconização da American Heart Association 2010, sendo que a atualização é essencial/primordial para um atendimento rápido e satisfatório.Descritores: Parada Cardiorrespiratória, Atenção Básica, Papel do Enfermeiro. Knowledge of cardiopulmonary arrest of nurses working in primary careAbstract: A cross study has been developed in order to identify the nurse’s knowledge from the basic health assistance while assisting a cardiorespiratory arrest. Twenty four nurses from the basic health assistance of the city of Suzano were interviewed. Emergency situations, such as cardiorespiratory arrest, requires skills and initial steps in the proper care, however, it was possible to identify that nurses, who work at Basic Health Unit/Family Health Program, are not updated before the new 2010 American Heart Association preconization, considering that the update is essential to a satisfactory attendance.Descriptors: Cardiopulmonary Resuscitation, Primary Care, Role of the Nurse. El conocimiento de la parada cardiorrespiratória de los enfermeiros que trabajan en atención primariaResumen: Se desarrolló un estudio transversal con el objetivo de identificar el conocimiento del enfermero en la red básica de salud en la atención a la parada cardiorrespiratoria. Fueron entrevistados veinticuatro enfermeros de la red básica de salud del municipio de Suzano. Situaciones de emergencia, como la PCR, requieren habilidades y medidas iniciales que son primordiales en la atención adecuada, pero, fue posible identificar que los enfermeros que actúan en Unidad Basica de Salud/Programa de Salud Familiar, no están actualizados ante la nueva preconización de la American Heart Association 2010, siendo que la actualización es esencial/primordial para una atención rápida y satisfactoria.Descriptores: Resucitación Cardiopulmonar, Atención Primaria, Rol de lo Enfermero.

Dysphagia in Hospice Care: The Roles of Social Work and Speech-Language Pathologists

2014 ◽  
Vol 23 (4) ◽  
pp. 173-186 ◽  
Author(s):  
Deborah Hinson ◽  
Aaron J. Goldsmith ◽  
Joseph Murray
Keyword(s):  
Social Work ◽  
End Of Life ◽  
Case Studies ◽  
End Of Life Care ◽  
Hospice Care ◽  
Patient Communication ◽  
Life Care ◽  
Speech Language Pathologists ◽  
Four Levels

This article addresses the unique roles of social work and speech-language pathologists (SLPs) in end-of-life and hospice care settings. The four levels of hospice care are explained. Suggested social work and SLP interventions for end-of-life nutrition and approaches to patient communication are offered. Case studies are used to illustrate the specialized roles that social work and SLP have in end-of-life care settings.

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