REAppropriate: Research update

Back in 2015, staff took part in REAppropriate, a survey-based research study that examined the perceptions of inappropriate cardiopulmonary resuscitation by emergency ambulance and hospital clinicians.

This study has just been published in Resuscitation. (Please note that this is only free to access until 7th November).

The authors’ key findings and recommendations:

  • 78% survey respondents perceived their last CPR attempt as appropriate, 14% were uncertain about its appropriateness and 8% perceived inappropriateness; survival to hospital discharge was 15%, 2% and 3%, respectively
  • The most important determinants of perception of inappropriate CPR were a non-shockable initial rhythm, a non-witnessed arrest, in older patients ( > 79 years) and in case of a “poor” first physical impression of the patient
  • A substantial number of patients are resuscitated without any realistic perspective of survival: more advance care planning conversations with patients and family are needed and clinician compliance with advance directives should be improved
  • There is a need for all clinicians involved in a resuscitation to receive feedback on the outcome of their attempts
  • Factoring clinical judgment into the decision to (not) attempt CPR may reduce harm inflicted by excessive resuscitation attempts and result in more dignified death.

To learn more about the research projects currently taking place within the Trust and how you can get involved, contact Larissa Prothero.

Published 6th October 2018

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