The Ethics of Real-Time EMS Direction: Suggested Curricular Content

Abstract

Ethical dilemmas can create moral distress in even the most experienced emergency physicians (EPs). Following reasonable and justified approaches can help alleviate such distress. The purpose of this article is to guide EPs providing Emergency Medical Services (EMS) direction to navigate through common ethical issues confronted in the prehospital delivery of care, including protecting privacy and confidentiality, decision-making capacity and refusal of treatment, withholding of treatment, and termination of resuscitation (TOR). This requires a strong foundation in the principles and theories underlying sound ethical decisions that EPs and prehospital providers make every day in good faith, but will now also make with more awareness and conscientiousness. Brenner JM , Aswegan AL , Vearrier LE , Basford JB , Iserson KV . The ethics of real-time EMS direction: suggested curricular content. Prehosp Disaster Med. 2018;33(2):201-212.

Family Presence and Audience Effects on Cardiopulmonary Resuscitation: Perceptions of Pre-hospital Emergency Caregivers in Turkey

“…Cardiopulmonary resuscitation (CPR) includes performance of chest compressions, airway management, rescue breathing, rhythm detection, and shock delivery (if indicated) by an integrated team of highly trained rescuers who are competent both for in-hospital and out-of-hospital settings to the casualties thought to be in cardiac arrest[1]. Pre-hospital emergency caregivers (PECs) are confronted with a number of ethical considerations when they are on their way to treat a person who suffers an out-of-hospital cardiac arrest with CPR[2,3]. One of the conflicts in the pre-hospital setting is family-witnessed CPR called family presence during CPR (FPDR)[4–7].…”

Family Presence and the Press Effects on Prehospital Cardiopulmonary Resuscitation: Attitudes of a Group of Emergency Caregivers

“…Cardiopulmonary resuscitation (CPR) includes the performance of chest compressions, airway management, rescue breathing, rhythm detection, and shock delivery (if indicated) by an integrated team of highly trained rescuers who are competent both for in-hospital and out-ofhospital settings to the casualties thought to be in cardiac arrest (American Heart Association 2015). Prehospital emergency caregivers (PECs) are confronted with a number of ethical considerations when they are on their way to treat a person who suffers an out-of-hospital cardiac arrest with CPR (Ågård et al 2012;Brenner et al 2018). One of the conflicts in the prehospital setting is family-witnessed CPR called family presence during CPR (FPDR) (Abelsson and Lindwall 2018;Erbay 2014;Karlsson, Karlsson, and Hilli 2019;Torabi et al 2019).…”