The True Intention of Rescue Squads in Terms of the CPA Transportation of Cancer Patients in the Terminal Phase of the Disease Who Make a DNAR Order
- VernacularTitle:DNARの意思表示をしているがん終末期のCPA患者の搬送に対する救急活動を行う消防職員の真意
- Author:
Masayo MIYABAYASHI
1
;
Chikako NAKAMURA
2
Author Information
- Keywords: DNAR order; end of life care; CPA; advance directive
- From:Palliative Care Research 2019;14(2):67-72
- CountryJapan
- Language:Japanese
- Abstract: Background: Even for the emergency transportation of cancer patients in the terminal phase of the disease with a DNAR, all patients are transported while resuscitation is carried out. We examined how on-site rescue squads felt about this along with what was found therefrom. Methods: We conducted an anonymous questionnaire among 103 staff members involved in emergency activities in the area concerned. The contents included: Have you ever transported patients with a DNAR? If yes, what kind of activities did you carry out?; and If not bound by the Fire Services Act, what kind of activities would you have carried out? Results: Even if you express your DNAR order, they have no choice but to comply with the Fire Service Law. Even assuming that there is no Fire Service Law, about half of respondents responded to lifesaving treatment, but about half of them responded that they wanted to refuse transportation. Discussion: For rescue squads, a difference between resuscitation activities and transportation was observed. Lack of knowledge among those near the patient who request emergency transportation against the will of the patient is the major cause of transporting patients with a DNAR. In order to respect the will of patients, the permeation of advance care planning including decisions made by visiting physicians and the creation of advance directives and education of local residents are necessary.
