einstein (São Paulo). 01/Oct/2017;15(4):409-14.

Do not attempt resuscitation orders at the emergency department of a teaching hospital

Cássia Regina Vancini-Campanharo, Rodrigo Luiz Vancini, Marcelo Calil Machado Netto, Maria Carolina Barbosa Teixeira Lopes, Meiry Fernanda Pinto Okuno, Ruth Ester Assayag Batista, Aécio Flávio Teixeira de Góis

DOI: 10.1590/S1679-45082017AO3999

ABSTRACT

Objective:

To identify factors associated with not attempting resuscitation.

Methods:

A cross-sectional study conducted at the emergency department of a teaching hospital. The sample consisted of 285 patients; in that, 216 were submitted to cardiopulmonary resuscitation and 69 were not. The data were collected by means of the in-hospital Utstein Style. To compare resuscitation attempts with variables of interest we used the χ2 test, likelihood ratio, Fisher exact test, and analysis of variance (p<0.05).

Results:

No cardiopulmonary resuscitation was considered unjustifiable in 56.5% of cases; in that, 37.7% did not want resuscitation and 5.8% were found dead. Of all patients, 22.4% had suffered a previous cardiac arrest, 49.1% were independent for Activities of Daily Living, 89.8% had positive past medical/surgical history; 63.8% were conscious, 69.8% were breathing and 74.4% had a pulse upon admission. Most events (76.4%) happened at the hospital, the presumed cause was respiratory failure in 28.7% and, in 48.4%, electric activity without pulse was the initial rhythm. The most frequent cause of death was infection. The factors that influenced non-resuscitation were advanced age, history of neoplasm and the initial arrest rhythm was asystole.

Conclusion:

Advanced age, past history of neoplasia and asystole as initial rhythm were factors that significantly influenced the non-performance of resuscitation. Greater clarity when making the decision to resuscitate patients can positively affect the quality of life of survivors.

Do not attempt resuscitation orders at the emergency department of a teaching hospital

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