Background Cardiopulmonary resuscitation (CPR) is defined as chest compressions and rescue breaths and is a subset of resuscitation. Championed for the treatment for out-of-hospital cardiac arrest, CPR is now commonplace for in-hospital cardiac arrest (IHCA).
Method An online survey of staff involved in resuscitation for IHCA sought demographic information, perceptions on the CPR definition, survival rates from IHCA and perceptions in clinical scenarios.
Results Of 500 complete responses, specialties with representation included emergency medicine (25%), intensive care (14%) and cardiology (12%). Ninety-seven percent of respondents believed that CPR for IHCA included defibrillation, while 57.2% believed it included comprehensive resuscitation. 65% discussed defibrillation in CPR discussions with patients. Forty-eight percent of respondents offered CPR for IHCA with underlying metastatic malignancy, despite 62.4% estimating survival at <5%. In IHCA with severe aortic stenosis, 43% of those who estimated survival to be <10% would offer CPR. In elderly myocardial infarction, 29% would offer defibrillation alone. In refractory arrhythmic IHCA, 69.2% would offer further CPR and defibrillation while 36% would stop therapy and allow natural death.
Conclusion The common use of CPR in hospital level care reflects the broader definition of resuscitation. Offering CPR in situations with recognized poor outcomes was commonplace. Evidently for cardiology patients a more nuanced process is required. Recapturing the definition of CPR for clinicians and patients as only chest compressions and rescue breaths may allow clinicians to offer some forms of resuscitation as part of restorative treatment without CPR and facilitate the withholding CPR when potentially futile.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.