TY - JOUR
T1 - Cardiopulmonary Resuscitation and Do-Not-Resuscitate Orders
T2 - A Guide for Clinicians
AU - Loertscher, Laura
AU - Reed, Darcy A.
AU - Bannon, Michael P.
AU - Mueller, Paul S.
PY - 2010/1
Y1 - 2010/1
N2 - The do-not-resuscitate order, introduced nearly a half century ago, continues to raise questions and controversy among health care providers and patients. In today's society, the expectation and availability of medical interventions, including at the end of life, have rendered the do-not-resuscitate order particularly relevant. The do-not-resuscitate order is the only order that requires patient consent to prevent a medical procedure from being performed; therefore, informed code status discussions between physicians and patients are especially important. Epidemiologic studies have informed our understanding of resuscitation outcomes; however, patient, provider, and institutional characteristics account for great variability in the prevalence of do-not-resuscitate orders. Specific strategies can improve the quality of code status conversations and enhance end-of-life care planning. In this article, we review the history, epidemiology, and determinants of do-not-resuscitate orders, as well as frequently encountered questions and recommended strategies for discussing this important topic with patients.
AB - The do-not-resuscitate order, introduced nearly a half century ago, continues to raise questions and controversy among health care providers and patients. In today's society, the expectation and availability of medical interventions, including at the end of life, have rendered the do-not-resuscitate order particularly relevant. The do-not-resuscitate order is the only order that requires patient consent to prevent a medical procedure from being performed; therefore, informed code status discussions between physicians and patients are especially important. Epidemiologic studies have informed our understanding of resuscitation outcomes; however, patient, provider, and institutional characteristics account for great variability in the prevalence of do-not-resuscitate orders. Specific strategies can improve the quality of code status conversations and enhance end-of-life care planning. In this article, we review the history, epidemiology, and determinants of do-not-resuscitate orders, as well as frequently encountered questions and recommended strategies for discussing this important topic with patients.
KW - Cardiopulmonary resuscitation
KW - Do-not-resuscitate orders
KW - Informed consent
KW - Physician-patient communication
UR - http://www.scopus.com/inward/record.url?scp=72649085359&partnerID=8YFLogxK
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U2 - 10.1016/j.amjmed.2009.05.029
DO - 10.1016/j.amjmed.2009.05.029
M3 - Review article
C2 - 20102982
AN - SCOPUS:72649085359
SN - 0002-9343
VL - 123
SP - 4
EP - 9
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 1
ER -