And the default should be....??? @CerebralNurse
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How about no CPR for unwitnessed asystolic/PEA arrest (this is already usual practice in some places.) Maybe “opt-in” (somehow) otherwise if patient really wants it (most wont). But still HCP decision to proceed (eg no if obviously frail, yes if arrest at the gym….)
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Agree CPR should ideally be an opt in-when we are born we know one day we will have a cardiac arrest-so how can one not plan for this ? clinicians don’t usually knowingly embark on interventions indiscriminately, especially when poor outcomes are expected, but CPR is an exception
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Exactly. Off the top of my head I can’t think of any other “usual treatment” that is associated with <2% survival.
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Why did you pick some arbitrary number?
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It’s not arbitrary. Have you read the linked article? Survival drops dramatically after 80.
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Unwitnessed and/or non-shockable in elderly should prompt us to recognise that their outcome is abysmal (as pointed out in the article). The fact that we rationalise doing CPR (often >20mins duration) is the problem
Hvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi
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While I agree that this convo is important, and I generally agree with the premise that we need better criteria no CPR in select patients, I would urge us not to base this on one arbitrary cut-off of age without supporting data. Many 80s in great shape; many 60s who are moribund.
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Take an individual approach for sure
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Absolutely Dave. As you well know it is frustrating and distressing for
#paramedics having to deal with these issues in the field, when the conversation should have been had a long time before we end up there. ACDs should be mandatory on admission to nursing facilities.Hvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi
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