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Indian J Crit Care Med. 2017 Dec;21(12):865-868. doi: 10.4103/ijccm.IJCCM_314_17.

Practices and Perspectives in Cardiopulmonary Resuscitation Attempts and the Use of Do Not Attempt Resuscitation Orders: A Cross-sectional Survey in Sri Lanka.

Author information

1
Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka.
2
Mahidol Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand.
3
Academic Medical Centre, Amsterdam, Netherlands.
4
National Intensive Care Surveillance, Ministry of Health, Colombo, Sri Lanka.
5
Intensive Care National Audit and Research Centre, Sri Lanka.
6
Critical Care Research Team, Royal London Hospital, Queen Mary University of London, London, United Kingdom.
7
William Harvey Institute, Queen Mary University of London, London, United Kingdom.
8
Lady Ridgeway Hospital, Colombo, Sri Lanka.
9
Faculty of Medicine, University of Rajarata, Anuradhapura, Sri Lanka.
10
Government Medical Officers Association, Ministry of Health, University of Colombo, Colombo, Sri Lanka.
11
Office of Director Medical Services, Ministry of Health, University of Colombo, Colombo, Sri Lanka.
12
Office of Director General of Health Services, Ministry of Health, University of Colombo, Colombo, Sri Lanka.
13
Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.

Abstract

Objective:

The objective of this study is to describe the characteristics of in-hospital cardiopulmonary resuscitation (CPR) attempts, the perspectives of junior doctors involved in those attempts and the use of do not attempt resuscitation (DNAR) orders.

Methods:

A cross-sectional telephone survey aimed at intern doctors working in all medical/surgical wards in government hospitals. Interns were interviewed based on the above objective.

Results:

A total of 42 CPR attempts from 82 hospitals (338 wards) were reported, 3 of which were excluded as the participating doctor was unavailable for interview. 16 (4.7%) wards had at least 1 patient with an informal DNAR order. 42 deaths were reported. 8 deaths occurred without a known resuscitation attempt, of which 6 occurred on wards with an informal DNAR order in place. 39 resuscitations were attempted. Survival at 24 h was 2 (5.1%). In 5 (13%) attempts, CPR was the only intervention reported. On 25 (64%) occasions, doctors were "not at all" or "only a little bit surprised" by the arrest.

Conclusions:

CPR attempts before death in hospitals across Sri Lanka is prevalent. DNAR use remains uncommon.

KEYWORDS:

Cardiopulmonary resuscitation; critical care; do not attempt cardiopulmonary resuscitation; resource-limited; resuscitation

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