CPR in a hospice in perspective

doi:10.1136/bmj.b2344

Published 9 June 2009, doi:10.1136/bmj.b2344
Cite this as: BMJ 2009;338:b2344

Letters

Hospices and CPR guidelines

CPR in a hospice in perspective

The first 150 words of the full text of this article appear below.

National guidelines already contain sensible advice on decisionmaking about cardiopulmonary resuscitation (CPR) in very illpatients.¹ Currently, a fifth of this hospice’s inpatientsare potentially for CPR. This, I hope, is a valid surrogatemarker of non-discriminatory attitudes in our organisation.However, after 5800 patients and 18 years of care, we are yetto encounter our first patient requiring CPR.

Less than one out of hospital cardiac arrest is likely everytwo years in a setting where 250 adults over the age of 50 spend16 hours a day.² Increasing this statistic fivefold and applyingit to our day hospice, which offers 48 six hour places a week,we might expect one cardiac arrest every 22 years. An optimisticimmediate success rate of CPR of 5%, of whom 10% survive toreturn home, gives us one long term survivor per 200 CPR attempts.We might witness such success once . . . [Full text of this article]

John C Chambers, Macmillan consultant and medical director¹

¹ Katharine House Hospice, Adderbury, Oxfordshire OX17 3NL

john.chambers@khh.org.uk

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