• Ann Fr Anesth Reanim · Nov 2014

    Multicenter Study

    [Development of a tool for withholding and withdrawing life-sustaining treatment in the emergency room].

    • A Chirac, G David, N Rieg, A-M Schott-Pethelaz, J Bohe, F Carpentier, X Jacob, W Rhondali, and M Filbet.
    • Centre de soins palliatifs Pavillon 1K, CHU de Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France; Institut de psychologie, université de Lyon 2, 69500 Bron, France.
    • Ann Fr Anesth Reanim. 2014 Nov 1;33(11):555-62.

    ObjectivesActive treatment withholding and withdrawing decisions in the emergency room (ER) must be taken collegially according to ethical and juridical statements. Specific tools can support this process and our main goal was to create and validate such a tool.MethodWe created a first version of a tool to help for treatment withholding and withdrawing decisions inspired by similar documents from literature. Every item of this tool was then assessed by a group of experts (ER physicians and nurses) using the Delphi method to reach a consensus.ResultsThirty-four experts from eleven ER (academic, regional centre) were included and participate to the first round and twenty-seven to the second round. From the eighty-two-item tool, sixty-five items reach a consensus during these two rounds and were kept to constitute the final version of the tool.ConclusionWe have been able to create a tool to help for treatment withholding and withdrawing decisions adapted to the guidelines for end of life patient's management in the ER. This tool has been validated using a Delphi method by a group of experts from different centres. This multicentre validation will help for the diffusion and use of this tool in the different ER of the Rhône-Alpes region.Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

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