Physicians’ attitudes when faced with life-threatening events in children with severe neurological disabilities

2018-04-12T14:04:12Z (GMT) by Benjy Wosinski Christopher J. Newman
<p><b>Purpose:</b> Children with severe neurological disabilities are at an increased risk of acute, life-threatening events. We assessed physicians’ attitudes when making decisions in these situations.</p> <p><b>Methods:</b> We surveyed physicians in pediatric intensive care, neurology, and rehabilitation units in Swiss hospitals. The questionnaire explored participants’ attitudes toward life-threatening situations in two scenarios: a child with profound intellectual and multiple disabilities (PIMD) and an infant with spinal muscular atrophy (SMA) type I.</p> <p><b>Results:</b> The participation rate was 55% (52/95). There was a consensus favoring non-invasive ventilation and comfort care as well as avoiding tracheostomy and invasive ventilation. For the child with PIMD, 61% of participants opposed cardiopulmonary resuscitation (CPR), 51% for the child with SMA. Physicians with over 20 years of experience were significantly more opposed to providing CPR than less experienced colleagues.</p> <p><b>Conclusions:</b> Physicians held different views, influenced by personal factors. This highlights the importance of standardizing multidisciplinary processes toward approaching these complex situations.</p>