Cardiopulmonary Resuscitation - Could Be Inappropriate? The Emergency Medicine Professionals Perception In North-East Romania

Cardiopulmonary resuscitation (CPR) is started irrespective of comorbidity or cause of cardiac arrest. We aimed to determine the prevalence of perception of inappropriate CPR of the personnel from Emergency Department (ED), the factors associated with perception and the relation to patient characteristics. Material and methods: A survey based on questionnaire was conducted in an ED of University Hospital, as a part of multicentric European study. Factors associated with perception of CPR and outcome were analyzed on statistic base. Results: Of the 54 participating clinicians, 57.4% perceived their last CPR attempt as appropriate, 38.9 % were uncertain about its appropriateness and 3.7% perceived inappropriateness. The prevalence of perception of inappropriate CPR was higher when one of this factor was present: non-shockable initial rhythm, inappropriate quality of CPR performed by witnesses before arrival, the advanced age of the patient, terminal neoplasia, low quality of life before cardiac arrest. The ED staff needs an early recognition of CPR futility, feedback, training and teamwork and performance evaluation after each CPR attempt. Conclusions: The perception of inappropriate CPR is present in a small percent inside ED staff. Factoring clinical judgment into the decision to (not) attempt CPR may reduce harm inflicted by excessive resuscitation attempts.