Massive Pulmonary Embolism after a Short Episode of Physical Restraint in an Adolescent Psychiatric Patient.

Medical restraints, when used for short periods of time, can pose additional risk for deep vein thrombosis in adolescent psychiatric patients. The problem is often unrecognized, and there is a lack of awareness of this potential risk. However, as associated major adverse events may result in fatal outcomes, an individual patient's risk for deep vein thrombosis should be assessed and prophylactic anticoagulation may be indicated.

Is Every Life Worth Saving: Does Religion and Religious Beliefs Influence Paramedic's End-of-Life Decision-making? A Prospective Questionnaire-based Investigation.

BACKGROUND: Paramedics, arriving on emergency cases first, have to make end-of-life decisions almost on a daily basis. Faith shapes attitudes toward the meaning and worth of life itself and therefore influences decision-making. OBJECTIVE: The objective of this study was to detect whether or not religious and spiritual beliefs influence paramedics in their workday life concerning end-of-life decisions, and whether it is legally possible for them to act according to their conscience. METHODS AND DESIGN: This is a literature review of prior surveys on the topic using five key words and questionnaire-based investigation using a self-administered online survey instrument. SETTINGS/PARTICIPANTS: Paramedics all over Germany were given the opportunity to participate in this online questionnaire-based study. MEASUREMENTS: Two databases were searched for prior studies for literature review. Participants were asked about their religiosity, how it affects their work, especially in end-of-life situations, how experienced they are, and whether or not they have any legal latitude to withhold resuscitation. RESULTS: A total of 429 paramedics answered the questionnaire. Religious paramedics would rather hospitalize a patient holding an advance directive than leave him/her at home (P = 0.036) and think death is less a part of life than the nonreligious (P = 0.001). Otherwise, the Spearman's rho correlation was statistically insignificant for all tests regarding resuscitation. CONCLUSIONS: The paramedic's religiosity is not the prime factor in his/her decision-making regarding resuscitation.