Do Not Attempt CPR & ReSPECT

Dying is a natural process and is an unavoidable end to the process of living. Whilst there are times that attempting resuscitation is in the best interest of an individual who has had a cardiac arrest this is often not the most appropriate course of action. These decisions can be challenging and complex and where possible should be discussed in advance with individuals and those who are close to them or involved in their care. Decisions about when an individual should not be resuscitated may be documented as a Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) form, a  Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) form or and Advanced Decision to Refuse Treatment (ADRT).

DNACPR

A DNACPR is the decision and documentation that should an individual have a cardiac arrest then CPR should not be started. The DNACPR decision only relates to CPR and is not related to any other treatment prior to cardiac or respiratory arrest. The DNACPR decision may either be at an individual's request that they would not want CPR or that the team responsible for the individual's care feels CPR would either be unsuccessful or not in the best interest of the patient. A DNACPR decision may either be documented on a form similar to the one pictured below or within the individual's electronic notes. 

Advance Decision to Refuse Treatment

An ADRT, sometimes called a living will is a legally binding document written by an adult (over 18) l identifying treatments they refuse to have should they lack the capacity to make such a decision at the team the decision needs to be made. An ADRT can include the decision to refuse CPR should they have a cardiac or respiratory arrest as well as other treatments such as antibiotics for infection or if they would want to be ventilated should they become critically unwell.

For further practice on the skills involved in the ReSPECT process, including DNACPR, use the ReSPECT app to go through the procedures involved in the process in turn.

The teaching modules explain the ReSPECT process, who it’s for, how to fill in a ReSPECT form, how to prepare for a conversation and how to care for someone with a form.

Each module contains essential information and further reading if you would like to find out more. Essential information can be read, watched and listened to depending on your preference.

You can also take quizzes here to check your knowledge. Completing all the quizzes will allow you to download a certificate as evidence of your study.

If you don't already have an account, you'll need to create one. It's quick and easy and only requires an email address and for you to create a password. Click on the image below to open the app...

The Geeky Medics website has a page looking at how to approach discussions around DNACPR discussions. This is something which may be part of any health care professionals role and as such there is valuable information available here.

Geeky Medics - DNACPR Discussions

Date reviewed: 

Next review: August 2023