Cardiopulmonary Resuscitation: A Panacea or an Ethical Decision? Discussion Paper

The 'do not resuscitate' decision: guidelines for policy in the adult

The Royal College of Physicians of London, along with a number of organisations, has considered the policy for 'do not resuscitate' (DNR) orders in relation to cardiopulmonary resuscitation (CPR). On the basis of current attitudes towards the more active involvement of patients in such decisions--advance directives (living wills)--and the usual approach in the UK of seeking the views of relatives or next of kin, general guidelines have been drawn up which take into account the results obtained with CPR. The guidelines encompass only the broad principles, as it is envisaged that each hospital or unit will require a more detailed policy according to local circumstances and facilities. Children have not been included because of the special considerations that relate to neonatal resuscitation and the consents required.

Cardiopulmonary resuscitation: basic life support skills: 1

Basic life support (BLS) is potentially life-saving and unnecessary delays in starting BLS must be avoided. Sudden cardiac death occurs within 1 hour of symptoms in 40% of patients, and in 60% of young/middle-aged patients. BLS can support the casualty and save lives. Bystanders, including nurse aiders, should summon professional help before commencing BLS. Although technical expertise and equipment are necessary in specific situations, BLS 'buys time' while waiting for the equipment to arrive. Seventy per cent of cardiac arrests occur in the home and as BLS skills are often the only skills immediately available, their acquisition is essential.