Review questions: CPR

361.  What are some criteria for not starting resuscitative efforts on a victim of an in hospital cardiac arrest?

Few criteria can accurately predict the futility of continued resuscitation. In light of this uncertainty, all pediatric and adult patients who suffer cardiac arrest in the hospital setting should have resuscitative attempts initiated unless the patient has a valid DNAR order or has objective signs of irreversible death (eg,dependent lividity). A licensed physician’s order is necessary to withhold CPR in the hospital setting

362.  Does a DNR order carry any implications about all forms of medical treatment and care?

DNAR orders carry no implications about other forms of treatment. DNAR orders do not automatically preclude interventions such as administration of parenteral fluids, nutrition, oxygen, analgesia, sedation, antiarrhythmics, or vasopressors, unless these are included in the order. Some patients may choose to accept defibrillation and chest compressions but not intubation and mechanical ventilation.

363. What are some concerns that the rescuer may have about allowing a family member to be present during cardiac resuscitation?

One theoretical concern is the potential for family members to become disruptive, interfere with resuscitative procedures, or develop syncope, and another is the possibility of increased exposure to legal liability;

364.  Should family members be required to leave the room as resuscitative efforts are being performed?

In the absence of data documenting harm and in light of data suggesting that it may be helpful, offering select family members the opportunity to be present during resuscitation is reasonable and desirable.

365.  What is a strategy that the resuscitation team can take to assist a family member who has elected to be present during cardiac resuscitation?

Resuscitation team members should be sensitive to the presence of family members during resuscitative efforts, assigning a team member to remain with the family to answer questions, clarify information, and otherwise offer comfort.

The above questions (351-365) are based upon the information from the following source:

Laurie J. Morrison, Gerald Kierzek, Douglas S. Diekema, Michael R. Sayre, Scott M. Silvers, Ahamed H. Idris and Mary E. Mancini Part 3: Ethics : 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.  Circulation. 2010: 122: S665-S675

http://circ.ahajournals.org/


Reviewed 2/28/16