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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.