Cardiopulmonary resuscitation decisions - integrated adult policy: guidance

Scope of the Policy

This policy is specifically about cardiopulmonary resuscitation ( CPR), meaning treatment given with the aim of restoring sustainable spontaneous circulation and breathing when both have stopped. It does not indicate an advance decision about any other emergency treatment and/or care, including procedures that are sometimes loosely referred to as "resuscitation" such as rehydration, blood transfusion, intravenous antibiotics etc.

This policy applies to all NHSScotland Staff and the care of adult patients in all health and social care settings within the remit of NHSScotland. Independent care organisations and facilities are encouraged to make use of this NHSScotland policy for the benefit of their patients.

Due to the changing population of the prisons and the increasing number of patients who may die in custody, the policy also applies to all staff within Scottish Prisons including the two private prisons. Completion of a DNACPR form will be communicated to the relevant personnel within the prison, with the Governor having local responsibility regarding this. Communication with the patient in custody and their family regarding their health condition will remain the responsibility of NHS Staff. Local systems should be established to ensure appropriate communication between the NHS and Scottish Prison Service teams.

It is implicit in this policy that generally recommended practice may be altered in exceptional circumstances according to clinical judgement. In such a situation, clear documentation in the case notes is of prime importance to record actions and discussions, and to explain and justify the decision-making process.