title: [Assessment of withholding life support and withdrawing life support in a vital emergency department].
abstract: OBJECTIVE
  To evaluate the practices of withholding and withdrawing of life sustaining therapies in a vital emergencies department and to confront them with Leonetti law procedures.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  Collection of data performed by a physician (senior or junior) for all patients for whom a decision of withholding or withdrawing life sustaining treatments was taken.
  
  
  RESULTS
  Fifty-two patients were included. A withholding life sustaining treatments as non aggressive resuscitation procedures were instituted for 65% of the patients, of whom 85% were "waiting resuscitation". In 50% of the cases, the decision was taken by a single physician. The approval of the nursing staff was researched in 65% of the cases. The decision was written in the medical file in 94% of the cases. The patient's will was researched in 15% of the cases. The family was consulted about patient's will in 10% of the cases. The family was informed of the decision in 90% of the cases.
  
  
  CONCLUSIONS
  The application of Leonetti law in vital emergencies department is flawed. It appears to be necessary to realize new studies and to release official guidelines or recommendations specifically made for emergencies department to improve the practices of withholding or withdrawing life sustaining treatments.
authors.affiliation: Département d'anesthésie-réanimation, CHU de Toulouse, université de Toulouse, UPS, EA-MATN, institut de médecine moléculaire de Rangueil, IFR150, 31432 Toulouse, France.
authors.forename: M
authors.initials: M
authors.lastname: Verniolle
authors.forename: E
authors.initials: E
authors.lastname: Brunel
authors.forename: M
authors.initials: M
authors.lastname: Olivier
authors.forename: I
authors.initials: I
authors.lastname: Serres
authors.forename: A
authors.initials: A
authors.lastname: Mari
authors.forename: H
authors.initials: H
authors.lastname: Gonzalez
authors.forename: H
authors.initials: H
authors.lastname: Benhaoua
authors.forename: P
authors.initials: P
authors.lastname: Cougot
authors.forename: V
authors.initials: V
authors.lastname: Minville
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004632:Emergency Medical Services / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D005066:Euthanasia, Passive; D005190:Family; D005260:Female; D005602:France; D017408:Guidelines as Topic; D006801:Humans; D008020:Life Support Care / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010166:Palliative Care; D011446:Prospective Studies; D012151:Resuscitation; D013727:Terminal Care / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D028761:Withholding Treatment / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*