title: Prehospital providers' perceptions of emergency calls near life's end.
abstract: The nature of emergency end-of-life calls is changing as people live longer and die from chronic illnesses. This study explored prehospital providers' perceptions of (1) end-of-life 911 calls, (2) the signs and symptoms of dying, and (3) medical orders for life sustaining treatment (MOLST). The exploratory-descriptive pilot study was survey based and cross-sectional. Calls to nursing homes occur most often, (47.8% every shift). The MOLST was seen infrequently (57.9% rarely never). The most frequent signs and symptoms of dying were diagnosis (76%), hospice involvement (82%), apnea (75%), mottling (55%), and shortness of breath (48%). The MOLST identifies wishes about intubation (74%), resuscitation (74%), life-sustaining treatment (72%), and cardiopulmonary resuscitation (70%). Synergy exists between the fields of prehospital, hospice, and palliative medicine which offers potential for improved education and care.
authors.affiliation: University at Buffalo School of Social Work, Buffalo, NY, USA dwaldrop@buffalo.edu.
authors.forename: Deborah
authors.initials: D
authors.lastname: Waldrop
authors.affiliation: Department of Emergency Medicine, University at Buffalo School of Medicine, Buffalo, NY, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Clemency
authors.affiliation: University at Buffalo School of Social Work, Buffalo, NY, USA.
authors.forename: Eugene
authors.initials: E
authors.lastname: Maguin
authors.affiliation: Department of Emergency Medicine, University at Buffalo School of Medicine, Buffalo, NY, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Lindstrom
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004630:Emergencies; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D016414:Resuscitation Orders; D011795:Surveys and Questionnaires; D013689:Telephone; D013727:Terminal Care / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: emergency care; end-of-life care; end-of-life decision making; patient/family care