• Temple EM

Physician Orders for Life-Sustaining Treatment (POLST)

The Article:

Physician orders for life-sustaining treatment and emergency medicine: ethical considerations, legal issues, and emerging trends. Jesus JE et. al. Ann Emerg Med. 2014 Aug; 64(2):140-4.

The Idea:

In part due to the shortcomings of DNR/DNI and advance directives, Emergency physicians frequently treat the critically ill without knowing their patients’ end-of-life care preferences. The POLST is a relatively new tool that can help improve patient-centered end-of-life care.

The Paper:

This article provided a general overview of POLST and its application to Emergency Medicine. It specifically examined its evolution, ethical issues, implementation, and future considerations. It also briefly explored the evidence comparing it to DNR/DNI and advance directives.

The Findings:

POLST evolved out of a need to more clearly communicate patients’ end-of-life preferences regarding medical treatment. Although not perfect, it is an improvement on more established methods like DNR/DNI. POLST implementation must occur within a larger legal and medical framework. As cloud-based medicine becomes more prevalent, POLST will likely play a greater role in ED care.

The Takeaway:

Although universal POLST adoption is not around the corner, it represents an improved method of providing patient-centered care to ED patients.

Check out this link to the PA POLST form for more info – http://www.upmc.com/Services/AgingInstitute/partnerships-and-collaborations/Documents/POLST-Form.pdf

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