Overview

Overview

Cardiopulmonary Arrest, Cardiopulmonary Resuscitation (CPR) and Do Not Resuscitate (DNR)

Cardiopulmonary arrest means that your heart and breathing have stopped. When this happens, it is sometimes possible to restart your heart and breathing with an emergency treatment called cardiopulmonary resuscitation (CPR).

What interventions may be included in CPR?

Chest compressions are always the first intervention. They intend to pump blood out of the heart and to the main organs during CPR, until the heart starts pumping automatically again.

When you become unconscious because of cardiac or respiratory arrest, you are not able to breathe, cough or protect your lungs from aspiration. In order to increase the success of CPR, there needs to be high oxygen levels in your blood.

Respiratory assistance entails placing a breathing tube and connecting with a manual device or a breathing machine. Usually it takes time for you to breathe independently from the breathing machine. The breathing tube not only permits oxygen to flow, but also prevents aspiration of gastric content into the lungs.

Cardiac arrest sometimes presents arrhythmias that are treated with defibrillation or cardioversion, an electric shock delivered on the chest.

During cardiac arrest, resuscitative drugs are administered to re-start the heart and fix imbalances. An intravenous (IV) line is placed and used to administer medication during a cardiac or respiratory arrest. Cardiac Monitoring is initiated. In the same way that a pilot uses monitors on an airplane to make decisions about wind velocity and direction, doctors use monitors to determine which treatment are needed during CPR. Monitors will display oxygen levels in blood, heart rhythm, blood pressure, etc. Sometimes doctors have to do other invasive interventions, like aspirating air from your lung, or fluid from around your heart.

The information above describes what happens during cardiopulmonary resuscitation. The following sections describe information about do not resuscitate orders so that you may make informed decisions about your wishes.

Do Not Resuscitate (DNR) Orders

State of Ohio

A Do Not Resuscitate (DNR) order means that CPR is not to be conducted in case of cardiac or respiratory arrest. In the state of Ohio there are two DNR orders: DNR-CCA (Comfort Care Arrest) and DNR-CC (Comfort Care). Only a physician or Licensed Independent Practitioner can write a DNR order.

  • DNR-CCA orders permit the use of life-saving treatments before your heart or breathing stops. However, only comfort care is provided after your heart or breathing stops.
  • DNR–CC orders require that only comfort measures be administered before, during, or after the time your heart or breathing stops (as soon as the order is written). This type of order is generally regarded as proper for you if you have a terminal illness, short life expectancy, or little chance of surviving CPR. All treatments are directed towards keeping you comfortable and with the best quality of life possible.

State of Florida

In the state of Florida, there is only one DNR order. This order means that CPR will not be conducted in case of cardiac or respiratory arrest. If you want to forgo treatments before the heart or breathing stops, the doctor or a Licensed Independent Practitioner will write your specific wishes in the electronic medical record.

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