D o N ot A ttempt C ardio- P ulmonary R esuscitation (DNACPR). Dr Linda Wilson Consultant in Palliative Medicine Airedale/Manorlands. Both right - knowing when to do which and making it happen –that’s our challenge! .
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Dr Linda WilsonConsultant in Palliative Medicine Airedale/Manorlands
Both right - knowing when to do which and making it happen –that’s our challenge!
If cardiac or respiratory arrest is an expected part of the dying process and CPR will not be successful, making and recording an advance decision not to attempt CPR will help to ensure that the patient dies in a dignified and peaceful manner.
It may also help to ensure that the patient’s last hours or days are spent in their preferred place of care by, for example, avoiding emergency admission from a community setting to hospital.
GMC ‘Treatment and Care Towards the End of Life’ 2010
2007: Joint guidance on DNACPR from UK Resus. Council, BMA and RCN
2007: Mental Capacity Act 2005 (MCA) Code of Practice
2010: Treatment and care towards the end of life: good practice in decision making. GMC
2010:NHS Bradford & Airedale Joint Policy
Clinical experience, supported by the evidence in the literature, would suggest that CPR in patients with advanced, progressive cancer (and other advanced progressive conditions) who have poor performance status, and irreversible medical problems, can be classified as physiologically futile according to any definition.
Suzanne Kite THE LANCET Oncology Vol 3 October 2002
1. Futile with Capacity practice in decision making. GMC