Part 3: Ethical Issues: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

  title={Part 3: Ethical Issues: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.},
  author={Mary Elizabeth Mancini and Douglas Diekema and Theresa A. Hoadley and Kelly D. Kadlec and Marygrace Hernandez Leveille and Jane E Mcgowan and Michele M Munkwitz and Ashish R. Panchal and Michael R. Sayre and Elizabeth Sinz},
  volume={132 18 Suppl 2},
The goals of resuscitation are to preserve life; restore health; relieve suffering; limit disability; and respect individuals’ decisions, rights, and privacy. Because cardiopulmonary resuscitation (CPR) efforts must be initiated immediately at the time of arrest, a rescuer may not know who the victim is, what that individual’s goals of care are, or if an advance directive exists. As a result, administration of CPR may be contrary to the individual’s desires or best interests.1–3 This Part of… 

Figures from this paper

Ethical challenges in resuscitation

PurposeA rapidly evolving resuscitation science provides more effective treatments to an aging population with multiple comorbidites. Concurrently, emergency care has become patient-centered. This

First Do No Harm in End-of-Life Care: A Comment on the 2015 American Heart Association Guidelines for Post-Resuscitation Care of Cardiopulmonary Arrest

The emphasis on organ donation instead of best practices in end-of-life care and palliation in patients who are deemed terminal after cardiopulmonary resuscitation is a missed opportunity to ensure that the practice guidelines are patient-centered.

Duration of Cardiac Arrest Resuscitation: Deciding When to "Call the Code".

The authors argued that the time intervals were similar across all 4 stratified patient groups (shockable/nonshockable, bystander CPR present/absent), and, as such, the “shockable” rhythm group was used to determine the resuscitation time recommendations.

A critical review of the factors leading to cardiopulmonary resuscitation as the default position of hospitalized patients in the USA regardless of severity of illness

A critical review of the historical factors reveals that the rapid dissemination of cardiopulmonary training for the public, inaccuracies in the media regarding successful cardiopULmonary resuscitation, well-meaning legislative efforts with inadvertent consequences, and judicial interpretation outside the generally accepted concept of malpractice law have contributed to the situation faced by today’s physicians and hospitals in the USA.

Part 7: Systems of Care: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

Recommendations about community initiatives to promote cardiac arrest recognition, cardiopulmonary resuscitation, public access defibrillation, mobile phone technologies to summon first responders, and an enhanced role for emergency telecommunicators are included.

Early Identification of Patients With Out-of-Hospital Cardiac Arrest With No Chance of Survival and Consideration for Organ Donation

This study evaluated objective and practical criteria for identifying patients with OHCA and no chance of survival during the first minutes of advanced CPR to determine whether offering relatives of patients the choice of observing CPR would reduce the likelihood of symptoms of posttraumatic stress disorder.

Moving from “Do Not Resuscitate” Orders to Standardized Resuscitation Plans and Shared-Decision Making in Hospital Inpatients

A process based on standardized resuscitation plans has been shown to increase the frequency and clarity of documentation, reduce stigma attached to the documentation of a No-CPR order, and support the delivery of medically appropriate and desired care for the hospital patient.

Commence, continue, withhold or terminate?: a systematic review of decision-making in out-of-hospital cardiac arrest

  • N. AndersonM. GottJ. Slark
  • Medicine
    European journal of emergency medicine : official journal of the European Society for Emergency Medicine
  • 2017
This systematic integrative review identifies all research papers examining resuscitation providers’ perspectives on resuscitation decision-making for out-of-hospital cardiac arrest patients and identifies five themes, describing factors informing resuscitation provider decision- making: the arrest event; patient characteristics; the resuscitation scene; resuscitations provider perspectives; and medicolegal concerns.

Between a Rock and a Hard Place: Terminating Cardiopulmonary Resuscitation and Preserving Opportunities for Organ Donation

Using data from 3 French and U.S. cohorts totaling nearly perfect prediction of nonsurvivability using 3 simple criteria, the authors propose that these criteria be used to make termination-of-resuscitation decisions in the field or to transport identified patients to a hospital setting before termination.



Part 3: ethics: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

Although healthcare providers must play a role in resuscitation decision making, they should be guided by science, the individual patient or surrogate preferences, local policy, and legal requirements.

An official American Thoracic Society/International Society for Heart and Lung Transplantation/Society of Critical Care Medicine/Association of Organ and Procurement Organizations/United Network of Organ Sharing Statement: ethical and policy considerations in organ donation after circulatory determi

  • C. GriesD. White S. Halpern
  • Medicine, Political Science
    American journal of respiratory and critical care medicine
  • 2013
A framework to guide ethics and health policy statement was established, which addressed the consent process, pre- and post mortem interventions, the determination of death, provisions of end-of-life care, and pediatric DCDD.

Part 9: post-cardiac arrest care: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

The goal of immediate post-cardiac arrest care is to optimize systemic perfusion, restore metabolic homeostasis, and support organ system function to increase the likelihood of intact neurological

Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

This section of the 2010 AHA Guidelines for CPR and ECC addresses cardiac arrest in situations that require special treatments or procedures beyond those provided during basic life support (BLS) and

An Under-Recognized Benefit of Cardiopulmonary Resuscitation: Organ Transplantation*

At least 1,000 organs transplants per year in the United States (> 5% of all organs transplanted from patients declared dead by neurologic criteria) are recovered from patients who received cardiopulmonary resuscitation, an unreported beneficial outcome of cardiopUL pulmonary resuscitation.

Donation after cardiocirculatory death: a call for a moratorium pending full public disclosure and fully informed consent

This paper argues that DCD donors may not yet be dead, and therefore that organ donation during DCD may violate the dead donor rule, and calls for a moratorium on the practice of DCD.

Part 2: Evidence Evaluation and Management of Conflicts of Interest: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations.

The current process, which incorporates the use of the GRADE methodology, culminated in the 2015 CoSTR publication, which in turn will inform the international resuscitation councils’ guideline development processes.

Duration of Cardiopulmonary Resuscitation and Illness Category Impact Survival and Neurologic Outcomes for In-hospital Pediatric Cardiac Arrests

CPR duration was independently associated with survival to hospital discharge and neurological outcome, and among survivors, neurological outcome was favorable for the majority of patients.

Prehospital emergency treatment of palliative care patients with cardiac arrest: a retrolective investigation

Strategic and therapeutic approaches in outpatient palliative care patients with cardiac arrest differ depending on medical qualification, and to reduce legal insecurity and to avoid resuscitation and a possible lengthening of the dying process, advance directives and/or “Do not attempt resuscitation” orders should be more readily available and followed more closely.

Effect of cardiopulmonary resuscitation training for parents of high-risk neonates on perceived anxiety, control, and burden.

CPR training is an important intervention for promoting a sense of control and reducing the anxiety and sense of burden experienced by parents of neonates at risk for cardiopulmonary arrest.