Hastane Öncesi Acil Tıp Çalışanları Perspektifinden Tanıklı Resüsitasyonun Etik Boyutu Üzerine Bir Araştırma

Abstract

Amaç: Hasta yakınları rutin olarak acil servis resüsitasyon odasından çıkarılmaktadır. Bu uygulamayı ağırlıklı olarak hastanın yararını güvence altına almak, sağlık personellerini ve hasta yakınlarını potansiyel risklerden korumak gibi nedenlere bağlamak mümkündür. Hastane öncesi acil tıp uygulamalarında tanıklı resüsitasyonu engellemek çoğu zaman mümkün değildir. Hastane öncesi acil tıp çalışanlarının tanıklı resüsitasyona etik bakış açılarını araştırmak ve araştırma sonucuna göre politika önerisinde bulunmak amaçlanmaktadır.
Yöntem: Araştırma prospektif tanımlayıcı tipte bir anket çalışması olarak tasarlanmıştır. 18 Şubat 2022 ile 18 Mart 2022 tarihleri arasında Kırşehir Sağlık İl Müdürlüğü İl Ambulans Servisi Başhekimliği bünyesinde çalışan ATT, paramedik, sağlık memuru, hemşire ve hekimlere hazırlanan anket yüz yüze uygulanmıştır.
Bulgular: Katılımcıların çoğunluğunun kadın, önlisans mezunu, ATT ve paramedik olduğu ve mesleki sürelerinin 6-10 yıl arasında olduğu bulunmuştur. ATT ve paramediklerin sorulara verdikleri yanıtlar karşılaştırıldığında sadece “Hastane öncesi alanda yaptığınız resüsitasyona hasta yakınlarının tanıklığı hastaya zarar verebilecek bir duruma neden olabilir mi?” sorusuna verilen cevapta istatistiksel olarak anlamlı farklılık saptanmıştır. Bunun yanında hastane öncesi alanda yapılan tanıklı resüsitasyonun etik boyutları aile ve aile dışı bireylerin tanıklığı, mesleki profesyonellik, hastanın mahremiyeti ve bilgi gizliliği, yas tutma süreci, sağlık personelinin güvenliği, zarar vermeme gibi başlıklar altında incelenmiştir.
Sonuç: Hastane öncesi alanda yapılan tanıklı resüsitasyonun birçok tartışmalı etik boyutu olup, bunlara ilişkin düzenlemeler ve eğitimlerin yapılması gerekmektedir.

Keywords

• Acil Tıp Etiği
• Hastane Öncesi Acil Tıp
• Klinik Etik
• Tanıklı Resüsitasyon
• Tıp Etiği

A Study on the Ethical Aspects of Witnessed Resuscitation from the Perspective of Prehospital Emergency Caregivers

Abstract

Aim: Patients' relatives are routinely removed from the emergency department resuscitation room. One can attribute this practice primarily to reasons such as safeguarding patient welfare, protecting medical personnel and patient's relatives from potential risks. In prehospital emergency medicine, it is often not possible to prevent witnessed resuscitation efforts. Prehospital emergency caregivers responding to cardiopulmonary arrest must focus only on the patient. It is aimed to investigate the ethical perspectives of prehospital emergency caregivers on witnessed resuscitation and to make policy recommendations according to the results of the research.
Methods: The study was designed as a prospective, descriptive survey. Between February 18, 2022 and March 18, 2022, the survey prepared for EMTs, paramedics, health officers, nurses, and physicians working in the ambulance service of Kırşehir Provincial Health Directorate was applied face-to-face.
Results: The majority of the participants were women, associate degree graduates, EMT, and paramedics, and their career duration was between 6-10 years. When comparing paramedic and EMT responses to the questions, a statistically significant difference was only found in the response to question “Does witnessing the resuscitation you perform in the prehospital area cause a situation that may harm the patient?”. Additionally, the ethical aspects of witnessed resuscitation in the prehospital setting were examined under the headings such as the witness of the family and nonfamily individuals, professionalism, patient privacy and confidentiality, the grieving process, medical staff safety, and nonmaleficence.
Conclusions: Witnessed resuscitation in the prehospital setting has many controversial ethical aspects and needs regulations and training in this regard.

Keywords

• Emergency Medicine Ethics
• Prehospital Emergency Medicine
• Clinical Ethics
• Witnessed Resuscitation
• Medical Ethics.

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