The Physician Orders for Life-Sustaining Treatment program: Oregon emergency medical technicians' practical experiences and attitudes

Objectives: To evaluate emergency medical technicians' (EMTs) experiences with the Physician Orders for Life-Sustaining Treatment (POLST) program and learn about attitudes regarding its effectiveness. Design: Anonymous survey mailed to a stratified random sample. Setting: Tri-County Portland, Oregon, area. Participants: A total of 572 Oregon EMT respondents (out of 1,048 surveys) were included in the analysis. Measurements: Survey questions about experiences with the POLST form and opinions about POLST. Results: Respondents were mostly male (76%) and paramedics (66%). Most respondents (73%) had treated a patient with a POLST, and 74% reported receiving education about POLST. EMTs reported that POLST, when present, changed treatment in 45% of cases. Seventy-five percent of the respondents agreed that the POLST form provides clear instructions about patient preferences, and 93% agreed that the POLST form is useful in determining which treatments to provide when the patient is in cardiopulmonary arrest. Fewer (63%) agreed that the form is useful in determining treatments when the patient has a pulse and is breathing. Conclusion: Most respondents have experience with the POLST program. EMTs find the POLST form useful and often use it to change treatment decisions for patients.