End of life care: Cardiopulmonary resuscitation (CPR)

1. 128. When someone suffers sudden cardiac or respiratory arrest, CPR attempts to restart their heart or breathing and restore their circulation. CPR interventions are invasive and include chest compressions, electric shock by an external or implanted defibrillator, injection of drugs and ventilation. If attempted promptly, CPR has a reasonable success rate in some circumstances. Generally, however, CPR has a very low success rate and the burdens and risks of CPR include harmful side effects such as rib fracture and damage to internal organs; adverse clinical outcomes such as hypoxic brain damage; and other consequences for the patient such as increased physical disability. If the use of CPR is not successful in restarting the heart or breathing, and in restoring circulation, it may mean that the patient dies in an undignified and traumatic manner.

Subsections:

• When to consider making a Do Not Attempt CPR (DNACPR) decision (paragraphs 129-131)
• Discussions about whether to attempt CPR (paragraphs 132-133)
• When CPR will not be successful (paragraphs 134-136)
• When CPR may be successful (paragraphs 137-141)
• Resolving disagreements (paragraph 142)
• Recording and communicating CPR decisions (paragraph 143)
• Treatment and care after a DNACPR decision (paragraphs 144-145)
• Emergencies and CPR (paragraph 146)