Child ReSPECT

Dying is a natural process and is an unavoidable end to a person's life. 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 Limitation of Treatment Agreement (LOTA), or a Recommended Summary Plan for Emergency Care and Treatment (ReSPECT).

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 (if they are able/of age to make that decision) 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. 

ReSPECT

The ReSPECT process creates a summary of personalised recommendations for a person’s clinical care in a future emergency in which they do not have capacity to make or express choices. Such emergencies may include death or cardiac arrest, but are not limited to those events.  RESUS COUNCIL (2021). See below for the Child Young Persons' Advanced Care Plan Collaborative. This has been written in conjunction with the ReSPECT process.

TRUST POLICIES

There are a number of trusts that provide community treatment for children but they do not provide the diagnosis or acute treatment for the child. In each of these trusts there will be a policy that covers DNACPR/LOTA/ReSPECT. Please ensure if you are on placement in one of these areas that you read the appropriate policies.