Multiple Cardio-Pulmonary Resuscitation Attempts In A Community Hospital: How Well Do We Recognize Futility?

Bobe, Lohaliz; Evans, Laura; Klapholz, Ari; Calandriello, Alexandra; Dinan, William

doi:10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a6696

Cited by 1 publication

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“…Studies consistently show that the probability of successful resuscitation is heavily dependent on the patient’s overall medical condition. Underlying malignancy [ 25 – 27 ], coexisting chronic health conditions [ 25 , 28 , 29 ], coexisting organ failure [ 29 , 30 ], need for vasopressor support [ 31 , 32 ], prior need for CPR [ 33 , 34 ], and advanced age [ 25 , 35 – 37 ] all bode for a very poor outcome with successful CPR almost universally measured in the single digits.…”

Section: The American Heart Association and Cprmentioning

confidence: 99%

A critical review of the factors leading to cardiopulmonary resuscitation as the default position of hospitalized patients in the USA regardless of severity of illness

Georgiou

Georgiou²

2019

Int J Emerg Med

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BackgroundPhysicians are occasionally faced with patients requesting full resuscitation against medical advice. More commonly, neither patients nor their family members make such a request, but physicians simply presume that providing cardiopulmonary resuscitation comports with the patient’s wishes. In the USA, in contrast to other countries, a unilateral Do-Not-Resuscitate order by the physician is either forbidden by State Statute or not enforced by hospital policy. Unless otherwise specified, performing cardiopulmonary resuscitation on all hospitalized patients, regardless of the severity of the underlying illness, is the default position. Unlike other medical interventions, no deference is given to the medical judgment of the physician even when a patient is in the last days of a terminal illness. We examine the factors that have led to cardiopulmonary resuscitation having this unique status.Main bodyA review of the historical factors leading to cardiopulmonary resuscitation as the default position was undertaken. Articles published in the medical literature, lay-press articles, legislative enactments of law, and judicial opinions involving the issue of Do-Not-Resuscitate and cardiopulmonary resuscitation were reviewed regarding their impact on physician and hospital practice in the USA.ConclusionA critical review of the historical factors reveals that the rapid dissemination of cardiopulmonary training for the public, inaccuracies in the media regarding successful cardiopulmonary resuscitation, well-meaning legislative efforts with inadvertent consequences, and judicial interpretation outside the generally accepted concept of malpractice law have contributed to the situation faced by today’s physicians and hospitals in the USA.

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