By Mary Fran Hazinski, John M. Field
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Additional info for 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science
Support Care Cancer. 2009. 3. Miller W, Levy P, Lamba S, Zalenski RJ, Compton S. Descriptive analysis of the in-hospital course of patients who initially survive outof-hospital cardiac arrest but die in-hospital. J Palliat Med. 2010;13: 19 –22. 4. ACEP Policy Statement: Code of Ethics for Emergency Physicians. Am College of Emergency Physicians. idϭ29144. Accessed 5 May, 2010. 5. Marco CA, Bessman ES, Schoenfeld CN, Kelen GD. Ethical issues of cardiopulmonary resuscitation: current practice among emergency physicians.
Mangurten J, Scott SH, Guzzetta CE, Clark AP, Vinson L, Sperry J, Hicks B, Voelmeck W. Effects of family presence during resuscitation and invasive procedures in a pediatric emergency department. Journal of Emergency Nursing. 2006;32:225–233. McGahey-Oakland PR, Lieder HS, Young A, Jefferson LS, McGaheyOakland PR, Lieder HS, Young A, Jefferson LS. Family experiences during resuscitation at a children’s hospital emergency department. Journal of Pediatric Health Care. 2007;21:217–225. Jones M, Qazi M, Young KD.
Without objective signs of irreversible death (eg, decapitation, rigor mortis, or decomposition) and in the absence of known advance directives declining resuscitative attempts, full resuscitation should be offered. Conditions such as irreversible brain damage or brain death cannot be reliably assessed or predicted at the time of cardiac arrest. Withholding resuscitation and the discontinuation of life-sustaining treatment during or after resuscitation are ethically equivalent. In situations where the prognosis is uncertain, a trial of treatment may be initiated while further information is gathered to help determine the likelihood of survival, the patient’s preferences, and the expected clinical course (Class IIb, LOE C).