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Year : 2017  |  Volume : 21  |  Issue : 12  |  Page : 865--868

Practices and perspectives in cardiopulmonary resuscitation attempts and the use of do not attempt resuscitation orders: A cross-sectional survey in Sri Lanka


1 Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka; Mahidol Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand; Academic Medical Centre, Amsterdam, Netherlands
2 Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka; National Intensive Care Surveillance, Ministry of Health, Colombo, Sri Lanka; Intensive Care National Audit and Research Centre, London, United Kingdom
3 Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka
4 Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka; Critical Care Research Team, Royal London Hospital; William Harvey Institute, Queen Mary University of London, London, United Kingdom
5 Lady Ridgeway Hospital, Colombo; Faculty of Medicine, University of Rajarata, Anuradhapura; Government Medical Officers Association, Sri Lanka
6 National Intensive Care Surveillance, Ministry of Health; Office of Director Medical Services, Ministry of Health, University of Colombo, Colombo, Sri Lanka
7 Office of Director General of Health Services, Ministry of Health, University of Colombo, Colombo, Sri Lanka
8 Network for Improving Critical Care Systems and Training; National Intensive Care Surveillance, Ministry of Health, Colombo, Sri Lanka
9 Mahidol Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
10 Network for Improving Critical Care Systems and Training; Mahidol Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand; National Intensive Care Surveillance, Ministry of Health; Faculty of Medicine, University of Colombo, Colombo, Sri Lanka

Correspondence Address:
Dr. Rashan Haniffa
National Intensive Care Surveillance, Quality Secretariat Building, Castle Street Hospital for Women, Colombo 08

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijccm.IJCCM_314_17

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Objective: The objective of this study is to describe the characteristics of in-hospital cardiopulmonary resuscitation (CPR) attempts, the perspectives of junior doctors involved in those attempts and the use of do not attempt resuscitation (DNAR) orders. Methods: A cross-sectional telephone survey aimed at intern doctors working in all medical/surgical wards in government hospitals. Interns were interviewed based on the above objective. Results: A total of 42 CPR attempts from 82 hospitals (338 wards) were reported, 3 of which were excluded as the participating doctor was unavailable for interview. 16 (4.7%) wards had at least 1 patient with an informal DNAR order. 42 deaths were reported. 8 deaths occurred without a known resuscitation attempt, of which 6 occurred on wards with an informal DNAR order in place. 39 resuscitations were attempted. Survival at 24 h was 2 (5.1%). In 5 (13%) attempts, CPR was the only intervention reported. On 25 (64%) occasions, doctors were “not at all” or “only a little bit surprised” by the arrest. Conclusions: CPR attempts before death in hospitals across Sri Lanka is prevalent. DNAR use remains uncommon.






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