When Rose was found by her niece, nobody knew when she had suffered her cardiac arrest. The longer the “down time” (time from cardiac arrest to beginning of CPR), the less likely it is that resuscitation attempts will be successful. A number of policy documents have been produced to support decisions around adult CPR:
- Scottish Government, 2016:Do Not Attempt Cardiopulmonary Resuscitation: Integrated Adult Policy
- Respect: Recommended Summary Plan for Emergency Care & Treatment
- Decisions relating to Cardiopulmonary Resuscitation: Guidance from British Medical Association, the Resuscitation Council (UK) and the Royal College of Nursing (2016)[PDF]
As has been seen in the previous section, with an ageing population and increasing numbers of people with multiple conditions, anticipatory care plans with accompanying DNACPR forms are becoming more common. Had Jill known that Rose had completed a DNACPR form and had this information been recorded on Rose’s KIS, then emergency services would have been aware of the situation and CPR attempts may not have taken place.
Looking at the environment in which Rose was found, then it might have been suspected that she had multiple conditions, an anticipatory care plan and, possibly, a DNACPR form:
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Rose’s case highlights two issues:
- the importance of all family members being aware that an individual has completed a DNACPR form
- the importance of information being recorded in the KIS, so that all agencies are aware of a patient’s wishes should they experience a cardiac arrest
However, if there is any doubt about whether CPR should or should not be performed, commencing is considered to be is in the best interests of the patient. This should be continued until a paramedic or suitably trained professional informs the responders that treatment should be discontinued.
Clear discussion about wishes don’t always take place between health professionals with patients that may benefit from having them or between family members who may want to be informed of individual wishes.
Case Notes:
these would include Rose’s anticipatory care plan and her DNACPR form.
Zimmer Frame
Rose has obvious mobility problems.
Community Alarm
this has been issued due to Rose’s frailty, her medical conditions and the fact that she lives alone.
Medications pack
the fact that Rose has multiple medications, provided in a Venapak, indicates that she has problems remembering when to take her medications.
Post-its
Rose appears to have been using post-its as memory prompts, suggesting that she has short-term memory deficits.
Bandaged leg
Rose’s bandaged leg requires input from community nursing services.
Page last reviewed: 15 Oct 2020
