Jennifer Worth - In the Midst of Life

4* A joule is a unit of heat, energy and force – in this case electricity.

5* For an update, see Appendix I, Medical Aspects of Cardio-Pulmonary Resuscitation, by David Hackett, MD, FRCP, FESC.

6* From Shirley Rosen,‘ Truman of St Helens’, published by Madrona Publishers, Seattle, Washington State, 1981

7* Dylan Thomas, 1951.

8* The Resuscitation Council. http://www.resus.org.uk/SiteIndx.htm

9* The Resuscitation Council. http://www.resus.org.uk/pages/mediMain.htm

10* Gwinnutt C, Columb M, Harris R. Outcome after cardiac arrest in adults in UK hospitals: effect of the 1997 guidelines. Resuscitation 2000; 47: 125-135. http://www.resuscitationjournal.com/article/S0300-9572(00)00212-4/abstract f National Cardiac Arrest Audit (NCAA). https://www.icnarc.org/

11* Diem SJ, Lantos JD, TulskyJA. Cardiopulmonary Resuscitation on Television - Miracles and Misinformation. New Engl J Med 1996; 334: 1578-152. http://content.nejm.org/cgi/content/short/334/24/1578

12† Stiell IG, Wells GA, Field B et al, for the Ontario Prehospital Advanced Life Support Study Group. Advanced Cardiac Life Support in Out-of-Hospital Cardiac Arrest. New EnglJ Med 2004; 3 51:647-656.http://content.nejm.org/cgi/content/short/351/7/647 £ HerlitzJ, Bang A, GunnarssonJ, EngdahlJ, Karlson BW, LindqvistJ, Waagstein L. Factors associated with survival to hospital discharge among patients hospitalised alive after out-of-hospital cardiac arrest: change in outcome over 20 years in the community of Goteborg, Sweden. Heart 2003; 89: 25-30. http://heart.bmj.com/content/89/1/25.abstract

13* Sasson C, Rogers MAM, Dahl J, Kellermann AL. Predictors of Survival From Out-of-Hospital Cardiac Arrest. A Systematic Review and Meta-Analysis. Circulation: Cardiovascular Quality and Outcomes. 2010; 3: 63-81. http://circoutcomes.ahajournals.org/cgi/content/short/3/1/63

14† The Public Access Defibrillation Trial Investigators. Public-Access Defibrillation and Survival after Out-of-Hospital Cardiac Arrest. New Engl J Med 2004; 351: 637- 646. http://content.nejm.org/cgi/content/short/351/7/637

15* Morrison LJ, Visentin LM, Kiss A, Theriault R, Eby D, Vermeulen M, Sherbino J, Verbeek PR, for the TOR Investigators. Validation of a Rule for Termination of Resuscitation in Out-of-Hospital Cardiac Arrest. New Engl J Med 2006; 355: 478- 487. http://content.nejm.org/cgi/content/short/355/5/478

16* Neumar RW, Nolan J P, Adrie C et al. Post-Cardiac Arrest Syndrome. Epidemiology, Pathophysiology, Treatment, and Prognostication. A Consensus Statement From the International Liaison Committee on Resuscitation. Circulation 2008; 118: 2452-2483. http://circ.ahajournals.org/

17† Fischer M, Fischera NJ, Schuttlerb J. One-year survival after out-of-hospital cardiac arrest in Bonn city: outcome report according to the ‘Utstein style’. Resuscitation 1997; 33: 233-243. http://www.resuscitationjournal.com/ X http://www.karenannquinlan.org/

18* The Resuscitation Council. http://www.resus.org.uk/pages/DNARrstd.htm

19† Allowing a Natural Death: http://allowingnaturaldeath.org/

20† The NHS National Gold Standards Framework Centre. http://www.goldstandards framework.nhs.uk/

21* The NHS Gold Standards Framework. http://www.goldstandardsframework. nhs.uk/

22† Avon, Somerset and Wiltshire Cancer Services Allow a Natural Death (do not attempt resuscitation) Order. http://www.aswcs.nhs.uk/

23† Dignity in Dying. http://www.dignityindying.org.uk/

24* Treatment and care towards the end of life: Good practice in decision making. http://www.gmc-uk.org/End_of_life.pdf_32486688.pdf

25* Mental Capacity Act 2005. http://www.opsi.gov.uk/acts/

26* The Resuscitation Council. http://www.resus.org.uk/pages/witness.htm

from How We Die, Sherwin B Nuland, Alfred A. Knopf, New York, 1993

It is very difficult to remove a feed-peg because it is a life-maintaining device. It requires a major medical/legal decision and this is not easy to come by.

Ahronheim, J C, Morrison, R S, Baskin, S A, Morris, J, Meier, D E. Treatment of the dying in the acute care hospital. Advanced dementia and metastatic cancer. Archives of Internal Medicine, 1996; 156: 2094-100.

A joule is a unit of heat, energy and force – in this case electricity.

For an update, see Appendix I, Medical Aspects of Cardio-Pulmonary Resuscitation, by David Hackett, MD, FRCP, FESC.

From Shirley Rosen,‘ Truman of St Helens’, published by Madrona Publishers, Seattle, Washington State, 1981

Dylan Thomas, 1951.

The Resuscitation Council. http://www.resus.org.uk/SiteIndx.htm

The Resuscitation Council. http://www.resus.org.uk/pages/mediMain.htm

Gwinnutt C, Columb M, Harris R. Outcome after cardiac arrest in adults in UK hospitals: effect of the 1997 guidelines. Resuscitation 2000; 47: 125-135. http://www.resuscitationjournal.com/article/S0300-9572(00)00212-4/abstract f National Cardiac Arrest Audit (NCAA). https://www.icnarc.org/

Diem SJ, Lantos JD, TulskyJA. Cardiopulmonary Resuscitation on Television - Miracles and Misinformation. New Engl J Med 1996; 334: 1578-152. http://content.nejm.org/cgi/content/short/334/24/1578

Stiell IG, Wells GA, Field B et al, for the Ontario Prehospital Advanced Life Support Study Group. Advanced Cardiac Life Support in Out-of-Hospital Cardiac Arrest. New EnglJ Med 2004; 3 51:647-656.http://content.nejm.org/cgi/content/short/351/7/647 £ HerlitzJ, Bang A, GunnarssonJ, EngdahlJ, Karlson BW, LindqvistJ, Waagstein L. Factors associated with survival to hospital discharge among patients hospitalised alive after out-of-hospital cardiac arrest: change in outcome over 20 years in the community of Goteborg, Sweden. Heart 2003; 89: 25-30. http://heart.bmj.com/content/89/1/25.abstract

Sasson C, Rogers MAM, Dahl J, Kellermann AL. Predictors of Survival From Out-of-Hospital Cardiac Arrest. A Systematic Review and Meta-Analysis. Circulation: Cardiovascular Quality and Outcomes. 2010; 3: 63-81. http://circoutcomes.ahajournals.org/cgi/content/short/3/1/63

The Public Access Defibrillation Trial Investigators. Public-Access Defibrillation and Survival after Out-of-Hospital Cardiac Arrest. New Engl J Med 2004; 351: 637- 646. http://content.nejm.org/cgi/content/short/351/7/637

Morrison LJ, Visentin LM, Kiss A, Theriault R, Eby D, Vermeulen M, Sherbino J, Verbeek PR, for the TOR Investigators. Validation of a Rule for Termination of Resuscitation in Out-of-Hospital Cardiac Arrest. New Engl J Med 2006; 355: 478- 487. http://content.nejm.org/cgi/content/short/355/5/478

Neumar RW, Nolan J P, Adrie C et al. Post-Cardiac Arrest Syndrome. Epidemiology, Pathophysiology, Treatment, and Prognostication. A Consensus Statement From the International Liaison Committee on Resuscitation. Circulation 2008; 118: 2452-2483. http://circ.ahajournals.org/

Fischer M, Fischera NJ, Schuttlerb J. One-year survival after out-of-hospital cardiac arrest in Bonn city: outcome report according to the ‘Utstein style’. Resuscitation 1997; 33: 233-243. http://www.resuscitationjournal.com/ X http://www.karenannquinlan.org/