title: Decision making by emergency physicians when assessing cardiac arrest patients on arrival at hospital.
abstract: OBJECTIVE
  To investigate the factors which influence decision making by experienced emergency physicians when they decide whether to (a) pronounce 'life extinct' in adult patients with non traumatic cardiac arrest while in the ambulance, or (b) bring them into the resuscitation room in the Emergency Department for further assessment/management.
  
  
  METHODS
  Qualitative study involving semi structured interviews and a focus group.
  
  
  METHODS
  Accident & Emergency (A&E) departments in the Yorkshire region.
  
  
  METHODS
  Fifteen emergency physicians (two clinical fellows, nine specialist registrars and four consultants) working in the Yorkshire region.
  
  
  RESULTS
  Six main themes were identified that impacted upon the decision making process: the doctor's past experience, ambulance service issues, prehospital care, patient characteristics, presence and views of relatives, and organisational issues.
  
  
  CONCLUSIONS
  The reasoning behind decisions made when a patient arrives at the Emergency Department in cardiac arrest is multifactorial. Strict guidelines would be difficult to construct since individuals vary in the importance they attach to different factors.
authors.affiliation: Emergency Department, York District Hospital, Wigginton Road, York YO31 8HE, UK. alockley@totalise.co.uk
authors.forename: A S
authors.initials: AS
authors.lastname: Lockey
authors.forename: R D
authors.initials: RD
authors.lastname: Hardern
mesh_terms: D000328:Adult; D000552:Ambulances; D001291:Attitude of Health Personnel; D003657:Decision Making; D004632:Emergency Medical Services; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D007398:Interpersonal Relations; D017063:Outcome Assessment, Health Care; D010820:Physicians / Q000523:psychology*; D012151:Resuscitation