Patient/carer representatives in our hospital felt it was important that healthcare professionals approach this topic not as a formulaic process, but that they respect this as one of the most important conversations the patient and carers may have in their disease journey. Patients and carers unanimously agreed that these videos would be important and of high value and were very supportive of the TalkCPR project. The hospital trust also has a patient and carer information and support co-ordinator, who was instrumental in setting up this meeting. The Patient/Carer Liaison Group (PLG) consisted at the time of enquiry of 24 individuals with either a background as a cancer patient, or as a current or past carer of someone with cancer. There is a need to explain this procedure better within society, and also to create reproducible ways of giving clinicians opportunities to gain confidence in talking about this challenging topic more.Īt the start of the project, Velindre NHS Trust’s patient/carer group were asked to comment on whether they considered videos, as a medium, to be appropriate for the purpose of conveying the key areas for this topic. Talking about CPR is important, and in fact it is best to discuss it when a person is still reasonably well, and can express an opinion on whether the intervention is something they would consider appropriate for themselves or not, should it become necessary in future. Rib fractures, internal bleeding, severe pain, collapsed lungs and brain damage can be short and longer term problems, if the patient survives. Witnessing and undergoing CPR can be traumatic and involves chest compressions, intravenous lines being placed, insertion of airways, electric shocks to the bare chest. Success rates of CPR in people with cancer that has spread, are as low as 1.9%. Hospital cardiac arrest teams and ambulance crews in the community have a duty to treat on arrival at a scene, and do not always know the prior health status of an individual they are called urgently to see.
Increasingly, CPR has been given in situations when it is either very unlikely to work, or is not going to work at all, for instance in slow deterioration towards the end of life in patients with chronic, long term conditions such as cancer and/or when people are in the last moments of life, dying naturally. This is a medical emergency, and CPR can be successful in particular in the young and in those where a defibrillator can treat a reversible fatal rhythm. Four videos were planned, two aimed at palliative care patients and the general public, and two further videos for healthcare professionals.Ĭardiopulmonary Resuscitation or CPR is an emergency procedure, with the aim of restarting heart and breathing when these have ceased to function. The national DNACPR steering group in Wales set out to bridge this information gap, and video resources were considered to be a useful means to provide information.
Patient information leaflets are increasingly relied upon in nearly all areas of medicine, but our patient groups have told us that they are often not read.
Such resources may prompt further, more informed discussions between healthcare professionals and patients/proxy.
VERONICA JARVIS MARK 3 PROFESSIONAL
įace-to-face discussions with a healthcare professional are important, but additional media resources can and should be used to help understand DNACPR towards the end of life and in palliative care settings. Fritz has talked about a ‘duty to consult’. The National Centre for Health and Care Excellence (NICE) has set out standards for end of life care stressing early, anticipatory planning. Not discussing DNACPR, when a form has been added to medical notes can be unlawful. The resuscitation council has stressed the importance of discussing DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) decisions with patients and proxy, and two recent high profile court cases have changed practice.
How can a palliative patient express his or her views on future emergency care options, if they have little or no information about what procedures like CPR (Cardiopulmonary Resuscitation) involve, beyond what they have seen on television programmes and in fictional media? One of the authors of this research study, MT, outlined these challenges in a Guardian newspaper article, in particular how this area of medicine is often misrepresented on television.
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