On TV it always seems clear and simple. A patient in the hospital goes into cardiac arrest and the medical team springs into action. After a few tense moments of furious activity, and only after all seems lost, the patient is successfully revived. A few scenes later the smiling and now fully healthy patient thanks the doctor and returns to his or her life as a professional athlete, parent of young children, or criminal mastermind.
Medical professionals know that in real life this is rarely the way it goes. Most patients who undergo cardiopulmonary resuscitation (CPR) are old, frail, and very sick. Many will die and many who survive CPR will die anyway before leaving the hospital. And many survivors will have severe neurological problems.
Now a physician states in JAMA Internal Medicine that hospitals need to change the way they view CPR. When it comes to applying continuous quality improvement processes to CPR, hospitals “tend to focus on the procedural aspects of CPR, such as time to first defibrillation” and the selection of medications, but they “do not regularly scrutinize CPR attempts for appropriate clinical indications.” The author, Jeffrey Berger, is an Associate Professor of Medicine at Stony Brook University School of Medicine and the Director of Clinical Ethics, and the chief of the Section of Hospice and Palliative Medicine at Winthrop University Hospital.
SOURCE: Larry Huston, Forbes
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