Resuscitation guidelines?

Are there any published resuscitation rules available on the net? In
particular, as a layman, I would like to know if resuscitation of a patient
such as described below would be considered appropriate.

The patient is 87 years old and is suffering from advanced terminal
oesophageal cancer. In the last three months she has suffered bilateral
pulmonary emboli along with chest and bladder infections which have all been
successfully treated. She also had a heart attack five weeks ago. She is
admitted to hospital with severely swollen feet and ankles due to heart
failure pending transfer the following day to a hospice. During the night
whilst being helped onto a bedpan she collapses.

Would, or should resuscitation be attempted as a matter of routine?

"." <none@none> wrote:
> Are there any published resuscitation rules available on the net? In
> particular, as a layman, I would like to know if resuscitation of a
> patient such as described below would be considered appropriate.
>
> The patient is 87 years old and is suffering from advanced terminal
> oesophageal cancer. In the last three months she has suffered bilateral
> pulmonary emboli along with chest and bladder infections which have all
> been successfully treated. She also had a heart attack five weeks ago. She
> is admitted to hospital with severely swollen feet and ankles due to heart
> failure pending transfer the following day to a hospice. During the night
> whilst being helped onto a bedpan she collapses.
>
> Would, or should resuscitation be attempted as a matter of routine?

There are no guidelines that address the specific circumstances that you
describe, each case is unique, only general guidelines for making
resuscitation decisions produced by the British Medical Association and the
Royal College of Nursing, and general guidelines in relation to ethical
dilemmas. If the patient has not been designated not for resuscitation then
a nurse is obliged to begin the resuscitation process even though the nurse
may think that this is futile. This is based on the principle that it is the
doctor's role to withhold treatment, not the nurse. However, some Trusts
have in their resuscitation policy the provision that a registered nurse may
withhold resuscitation if they deem it inappropriate. Ideally, a patient
like the one you describe should have discussed their resuscitation status
with the medical staff, health permitting, partly to ascertain the patient's
wishes, and a decision made, such as not for resuscitation. The family
should aware of the decision. Sometimes an impending birth, wedding or other
very significant event in the family can influence what a terminally-ill
patient hopes will happen. There comes a point when the likelihood of doing
good is far outweighed by the likelihood of causing harm, and this probably
applies to the example you describe.

	#1
.	Resuscitation guidelines? Are there any published resuscitation rules available on the net? In particular, as a layman, I would like to know if resuscitation of a patient such as described below would be considered appropriate. The patient is 87 years old and is suffering from advanced terminal oesophageal cancer. In the last three months she has suffered bilateral pulmonary emboli along with chest and bladder infections which have all been successfully treated. She also had a heart attack five weeks ago. She is admitted to hospital with severely swollen feet and ankles due to heart failure pending transfer the following day to a hospice. During the night whilst being helped onto a bedpan she collapses. Would, or should resuscitation be attempted as a matter of routine?

	#2
Phil Anthropist	Re: Resuscitation guidelines? "." <none@none> wrote: > Are there any published resuscitation rules available on the net? In > particular, as a layman, I would like to know if resuscitation of a > patient such as described below would be considered appropriate. > > The patient is 87 years old and is suffering from advanced terminal > oesophageal cancer. In the last three months she has suffered bilateral > pulmonary emboli along with chest and bladder infections which have all > been successfully treated. She also had a heart attack five weeks ago. She > is admitted to hospital with severely swollen feet and ankles due to heart > failure pending transfer the following day to a hospice. During the night > whilst being helped onto a bedpan she collapses. > > Would, or should resuscitation be attempted as a matter of routine? There are no guidelines that address the specific circumstances that you describe, each case is unique, only general guidelines for making resuscitation decisions produced by the British Medical Association and the Royal College of Nursing, and general guidelines in relation to ethical dilemmas. If the patient has not been designated not for resuscitation then a nurse is obliged to begin the resuscitation process even though the nurse may think that this is futile. This is based on the principle that it is the doctor's role to withhold treatment, not the nurse. However, some Trusts have in their resuscitation policy the provision that a registered nurse may withhold resuscitation if they deem it inappropriate. Ideally, a patient like the one you describe should have discussed their resuscitation status with the medical staff, health permitting, partly to ascertain the patient's wishes, and a decision made, such as not for resuscitation. The family should aware of the decision. Sometimes an impending birth, wedding or other very significant event in the family can influence what a terminally-ill patient hopes will happen. There comes a point when the likelihood of doing good is far outweighed by the likelihood of causing harm, and this probably applies to the example you describe.