Re: Help, quick question about full codes

[Sara Hayden RN,C]

I am an America Red Cross CPR for the professional rescuer instructor. Many facilities have it a part of their code policy that CPR will not commence unless the arrest was witnessed.  We have such a policy and when the patient is admitted to this facility, this is reviewed with them prior to their DNR decision.  They may change their mind on this decision at any time.  If they are unable to make an informed choice and have no one as their POA, we treat them as a full code until other legalities are handled.  We really try to work with our nurses to watch for changes in condition and summon EMS for changes.  EMS is expected to sustain any resuscitation attempts begun in the community, however, most advanced EMS are able to send strips to the physician in the hospital and then can have the Dr. pronounce based on the resuscitation protocol and lack of the patient's response to interventions.  We have added a defibrillator in our facility, but again, we try to get EMS into the building before it becomes a code. The last statistics I have regarding CPR is that only 3% of community arrests survive to be discharged from the hospital back into their community setting.    http://www.naemsp.org/position%20papers/termresus.html http://www.co.alameda.ca.us/publichealth/organization/divisions/ems/Resource_policy_manual/7207.pdf http://www.annals.org/cgi/content/full/138/1/65 http://circ.ahajournals.org/cgi/content/full/96/9/2849   Sara Hayden RN,C St. Mark's Lutheran Home Austin, MN   ----- Original Message ----- From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Monday, February 09, 2004 1:33 PM Subject: Re: Help, quick question about full codes I would be very interested to hear what a certified CPR instructor would have to say about this.  Anyone out there certified to teach CPR?  (Every class I have ever taken has emphasized that CPR must be started unless the patient has a properly documented No CPR or equivalent order, and CPR continues until someone else takes over or until the rescuer is too exhausted to continue.) Rena Rena R. Shephard, MHA, RN, FACDONA, RAC-C Chair, American Association of Nurse Assessment Coordinators [EMAIL PROTECTED] Subj: RE: Help, quick question about full codes Date: 2/9/04 11:16:15 AM Pacific Standard Time From: [EMAIL PROTECTED] Reply-to: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent from the Internet I would appreciate a copy also. Thanks, Betty H    (863)453-0769 Julie Thomas <[EMAIL PROTECTED]> wrote:                                                                                                                                                                                                         I would like a copy of your policy. 254-445-3960 Thank you, Julie Thomas RN BSN -----Original Message----- From: Connie L. Frank [mailto:[EMAIL PROTECTED] Sent: Friday, February 06, 2004 9:38 AM To: [EMAIL PROTECTED] Subject: RE: Help, quick question about full codes I will fax if I have your number. I do not have it in my computer files and I am unable to scan to email. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Libby Cawthorn Sent: Friday, February 06, 2004 9:06 AM To: [EMAIL PROTECTED] Subject: RE: Help, quick question about full codes   Would you mind sharing your policy? -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Connie L. Frank Sent: Friday, February 06, 2004 8:56 AM To: [EMAIL PROTECTED] Subject: RE: Help, quick question about full codes I would base it on your facility policy and if you don't have one....write one. Our policy is that we only code WITNESSED last breaths....   -----Original Message----- From: Davina Demerritt [mailto:[EMAIL PROTECTED] Sent: Friday, February 06, 2004 8:38 AM To: [EMAIL PROTECTED] Subject: Help, quick question about full codes   If a resident is a full code and you do not know when they took their last breathe, then you still start a code, correct?  I need this in writing please. --- Incoming mail is certified Virus Free. Checked by AVG anti-virus system (http://www.grisoft.com). Version: 6.0.576 / Virus Database: 365 - Release Date: 1/30/04 --- Outgoing mail is certified Virus Free. Checked by AVG anti-virus system (http://www.grisoft.com). Version: 6.0.576 / Virus Database: 365 - Release Date: 1/30/04