Exclusion from Resuscitation

Resuscitation was attempted for 156 (19.9%) of the 783 cases in St Thomas's Hospital, aged 16 or over, who suffered first cardiac or respiratory arrest of the current admission during the year to 13 April 1987. Seventeen (11%) of the 156 were discharged alive from hospital after resuscitation. All seventeen had been active outside the home before admission, and all except one remained so after discharge. The factors which were associated with exclusion from resuscitation attempts are analysed. Most accorded with known prognostic factors, but resuscitation was attempted for some persons who seemed to have little chance of benefiting from resuscitation attempts. Routine collection, analysis, and dissemination of information on pre-arrest characteristics in relation to their outcome, on which clinicians can base their decision to with-hold resuscitation in the event of an arrest, is recommended.