Clin Med
-
The decision to perform cardiopulmonary resuscitation (CPR) remains one of the most important and difficult decisions a physician must make. This study examined differences in CPR decision making among senior hospital clinicians. A questionnaire was sent out to consultants and specialist registrars in general medicine, elderly care and intensive care in a large UK district general hospital, with anonymous returns. ⋯ There were significant differences between specialties in making the decision to perform CPR and the confidence in doing so, with three cases producing polarised results within the specialties, despite equal confidence in the decision. There is lack of consensus with the CPR decisions made between specialties and within them. Formal training in recognition of futility should be encouraged for all clinicians.
-
The modified early warning score (MEWS) was developed as a track and trigger tool for the prompt identification of seriously ill patients on an acute medical ward. This paper examines its value in the setting of an acute medical admissions unit (MAU) and compares it to biochemical markers of acute and chronic disease. Three hundred unselected acute admissions to the MAU of the Queen Elizabeth Hospital, Gateshead, were assessed. ⋯ A raised CRP/albumin ratio was less sensitive for overall mortality than MEWS. It did, however, appear to be of greater value in the elderly, especially in those with acute exacerbations of chronic disease. Neither test accurately predicted length of stay.