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J R Soc Med. 1995 March; 88(3): 136–140.
PMCID: PMC1295131

Improving the documentation and appropriateness of cardiopulmonary resuscitation decisions.


A criterion based audit was undertaken, over a 3 year period, to review the appropriateness of the decision to undertake cardiopulmonary resuscitation (CPR) and the recording of resuscitation status in a 112 bedded department of medicine for the elderly. Resuscitation status was not recorded in either nursing or medical notes of patients undergoing CPR during the first two 12 month audit periods, and was recorded in 71% in the final 12 month audit period. The auditors agreed in 91% of cases that CPR was either appropriate or inappropriate. In the third year of audit 40% of decisions to resuscitate were judged inappropriate.

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Selected References

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  • Hershey CO, Fisher L. Why outcome of cardiopulmonary resuscitation in general wards is poor. Lancet. 1982 Jan 2;1(8262):31–34. [PubMed]
  • Peatfield RC, Sillett RW, Taylor D, McNicol MW. Survival after cardiac arrest in hospital. Lancet. 1977 Jun 11;1(8024):1223–1225. [PubMed]
  • Taffet GE, Teasdale TA, Luchi RJ. In-hospital cardiopulmonary resuscitation. JAMA. 1988 Oct 14;260(14):2069–2072. [PubMed]
  • Johnson AL, Tanser PH, Ulan RA, Wood TE. Results of cardiac resuscitation in 552 patients. Am J Cardiol. 1967 Dec;20(6):831–835. [PubMed]
  • Bedell SE, Delbanco TL, Cook EF, Epstein FH. Survival after cardiopulmonary resuscitation in the hospital. N Engl J Med. 1983 Sep 8;309(10):569–576. [PubMed]
  • Füsgen I, Summa JD. How much sense is there in an attempt to resuscitate an aged person? Gerontology. 1978;24(1):37–45. [PubMed]
  • Gulati RS, Bhan GL, Horan MA. Cardiopulmonary resuscitation of old people. Lancet. 1983 Jul 30;2(8344):267–269. [PubMed]
  • Wildsmith JA, Dennyson WG, Myers KW. Results of resuscitation following cardiac arrest. A review from a major teaching hospital. Br J Anaesth. 1972 Jul;44(7):716–720. [PubMed]
  • Kennelly BM. Analysis of a 2-year-old resuscitation service. Resuscitation. 1974;3(4):229–239. [PubMed]
  • Polta TA. Cardiopulmonary resuscitation at McKennan Hospital. S D J Med. 1973 May;26(5):17–22. [PubMed]
  • Scott RP. Cardiopulmonary resuscitation in a teaching hospital. A survey of cardiac arrests occurring outside intensive care units and emergency rooms. Anaesthesia. 1981 May;36(5):526–530. [PubMed]
  • Hahn RG, Hutchinson JC, Conte JE., Jr Cardiopulmonary resuscitation in a university hospital. An analysis of survival and cost. West J Med. 1979 Oct;131(4):344–348. [PMC free article] [PubMed]
  • Buff DD, Fleisher JM, Roca JA, Jaffri M, Wyrwinski PM. Circadian distribution of in-hospital cardiopulmonary arrests on the general medical ward. Arch Intern Med. 1992 Jun;152(6):1282–1288. [PubMed]
  • Stewart K, Abel K, Rai GS. Resuscitation decisions in a general hospital. BMJ. 1990 Mar 24;300(6727):785–785. [PMC free article] [PubMed]
  • Bayliss RI. Thou shalt not strive officiously. Br Med J (Clin Res Ed) 1982 Nov 13;285(6352):1373–1375. [PMC free article] [PubMed]
  • KOUWENHOVEN WB, JUDE JR, KNICKERBOCKER GG. Closed-chest cardiac massage. JAMA. 1960 Jul 9;173:1064–1067. [PubMed]
  • O'Keeffe S, Redahan C, Keane P, Daly K. Age and other determinants of survival after in-hospital cardiopulmonary resuscitation. Q J Med. 1991 Dec;81(296):1005–1010. [PubMed]
  • Bok S. Personal directions for care at the end of life. N Engl J Med. 1976 Aug 12;295(7):367–369. [PubMed]
  • Dyer Clare. High Court says advance directives are binding. BMJ. 1993 Oct 23;307(6911):1023–1024. [PubMed]
  • Shmerling RH, Bedell SE, Lilienfeld A, Delbanco TL. Discussing cardiopulmonary resuscitation: a study of elderly outpatients. J Gen Intern Med. 1988 Jul-Aug;3(4):317–321. [PubMed]
  • Gunasekera NP, Tiller DJ, Clements LT, Bhattacharya BK. Elderly patients' views on cardiopulmonary resuscitation. Age Ageing. 1986 Nov;15(6):364–368. [PubMed]
  • Doyal L, Wilsher D. Withholding cardiopulmonary resuscitation: proposals for formal guidelines. BMJ. 1993 Jun 12;306(6892):1593–1596. [PMC free article] [PubMed]
  • Topper Ruth, Lubel David. Resuscitation decisions in a general hospital. BMJ. 1990 May 12;300(6734):e1271–1272. [PMC free article]
  • Aarons EJ, Beeching NJ. Survey of "do not resuscitate" orders in a district general hospital. BMJ. 1991 Dec 14;303(6816):1504–1506. [PMC free article] [PubMed]
  • Bedell SE, Delbanco TL. Choices about cardiopulmonary resuscitation in the hospital. When do physicians talk with patients? N Engl J Med. 1984 Apr 26;310(17):1089–1093. [PubMed]
  • Stolman CJ, Gregory JJ, Dunn D, Levine JL. Evaluation of patient, physician, nurse, and family attitudes toward do not resuscitate orders. Arch Intern Med. 1990 Mar;150(3):653–658. [PubMed]
  • O'Keeffe ST, Noel J, Lavan JN. Cardiopulmonary resuscitation preferences in the elderly. Eur J Med. 1993 Jan;2(1):33–35. [PubMed]
  • Schade SG, Muslin H. Do not resuscitate decisions: discussions with patients. J Med Ethics. 1989 Dec;15(4):186–190. [PMC free article] [PubMed]
  • Blackhall LJ. Must we always use CPR? N Engl J Med. 1987 Nov 12;317(20):1281–1285. [PubMed]
  • George AL, Jr, Folk BP, 3rd, Crecelius PL, Campbell WB. Pre-arrest morbidity and other correlates of survival after in-hospital cardiopulmonary arrest. Am J Med. 1989 Jul;87(1):28–34. [PubMed]
  • Miles SH, Cranford R, Schultz AL. The do-not-resuscitate order in a teaching hospital: considerations and a suggested policy. Ann Intern Med. 1982 May;96(5):660–664. [PubMed]

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