If you’ve heard about ‘resuscitation’ (or ‘do not attempt resuscitation orders’) in the news recently, the term ‘resuscitation’ is probably being used as a shorthand to refer to ‘cardio pulmonary resuscitation’ (CPR). CPR is the specific treatment given when the heart has stopped, the person is unconscious and is not breathing.
CPR may include:
This is a distressing experience for everyone involved, with a very real physical toll on the patient. Many people who survive CPR have to cope with internal haemorrhages, fractures, collapsed lungs, brain injury and severe pain. Some survive in a coma, only to die soon after.
When does CPR help?
While CPR can help some people, we know that it does not work on people who are already very ill or frail. Where an illness is already affecting very seriously someone’s whole body, restarting their heart isn't going to solve the problem. Rather, CPR and its side effects can cause the last moments of their life to be filled with pain and distress.
Based on your existing underlying health, your doctor may be able to tell that CPR would not work for you. This is based a combination of factors that contribute to your overall health. It is unethical for medical/nursing staff to undertake a treatment that they know would not be successful, and which would also cause you distress. If this is the situation, then the professionals will make the decision to not undertake CPR. Although this is a decision taken by the medical team responsible for your care, it is important that they explain this to you.
In an emergency
In an emergency, medical staff may not have readily available information about a person’s underlying health, and not realise that attempting CPR would be futile, or that someone previously decided they didn’t want to have CPR. In this situation, they might attempt resuscitation, causing the person pain and distress with no hope of a recovery or against the person’s wishes.
CPR decisions
You are advised to discuss with your doctors and nurses whether or not you would benefit from CPR. If you would benefit from CPR you should also think about whether or not you’d want to have it. If you decide that you’d prefer not to have CPR, you can tell your GP or other healthcare professional, and ask them to complete a ‘Do Not Attempt Cardiopulmonary Resuscitation’ or DNACPR form for you. Some GPs are actively getting in touch with patients to discuss whether a DNACPR form would be appropriate for them.
A DNACPR form is a form designed to protect someone from being subjected to aggressive CPR treatment when it has no chance of stopping them dying. It can also be completed when a person has decided for whatever reason that they do not want CPR to be attempted. The form records the decision so that if your heart stops the information will be readily available to medical staff who will know not to start CPR.
Please note, completing a DNACPR form should have no effect on whether or not you are offered other forms of treatment. Decisions about whether someone with COVID-19 would benefit from other treatments (for example continuous positive airways pressure, non invasive ventilation, and invasive ventilation) are made independently of whether the person has a DNACPR form
More resources
You can learn more about resuscitation here:
