Critical Care and Shock

Cardiopulmonary resuscitation preferences among health professionals in Singapore

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Introduction: Attitudes and preferences for cardiopulmonary resuscitation (CPR) among healthcare providers are varied among individuals and across countries. The purpose of this study was to determine these preferences amongst health practitioners attending the 3rd General Scientific Meeting of the Society of Intensive Care Medicine (Singapore) held in September 2003.

Methods: The survey was conducted among physicians, nurses and other health care providers attending a lecture during the critical care meeting in Singapore. The 35-item questionnaire included information about age, gender, profession, and religion, but no other identifiers were used. There was no follow up of 3 non-responders out of the 125 health care practitioners surveyed. The results were analyzed using contingency tables.

Results: 122 questionnaires were returned. Mean age was 33.5 ± 8.5 years and 9.8% were physicians, 74.5% were nurses. Physicians were significantly older (p<0.006) compared to nurses. 34.4% said they wanted “full code”, while 16.4% indicated they had not thought about code status. 53.7% of respondents would decline CPR if they are older than 65 years, with nurses significantly more likely to decline (p<0.006). 87.4% would decline CPR with end-stage renal disease, 92.6% with AIDS. The majority (58.5%) felt that future quality of life should be the most important factor in determining code status, following age. Respondents considered sepsis (25.8%) to carry the worst prognosis after CPR, following cancer (19.2%), SARS (14.2%), and myocardial infarction and AIDS (13.3%).

Conclusions: Many health care providers in Singapore are often involved in CPR situations, but it is impressive how the majority of the respondents in our survey would not want full resuscitation efforts should they experience a cardiopulmonary arrest. It is also interesting that they would use age more than 65 years in their decision to decline CPR. Many of health practitioners are uncertain which medical conditions are the ones with worst prognosis after CPR.

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