Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) - integrated adult policy: guidance

Guidance on decision making and communications policy in relation to the NHSScotland Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) policy.


Unfortunately many patients and their relevant others have unrealistic expectations of the success of CPR and its consequences. Where CPR may be medically successful, realistic and honest explanations of the traumatic nature of the treatment and of the probability of survival to discharge can significantly influence the resuscitation choices of patients.

Consideration of the outcome of resuscitation should be as realistic as possible and take into account the clinical condition of the patient, the likely cause of the anticipated arrest and also the environment within which the patient is being cared.

It is recommended that medical decisions be made on the likely outcome of a prolonged resuscitation unless the patient is in a Coronary Care or Intensive Care setting.

A medical DNACPR decision should be based on the clinical judgement that effective CPR will fail in achieving sustainable breathing and circulation for the individual patient rather than any judgement about the quality of the life that may be achieved.

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