MEDICAL E D T ecis H - ions on cardiopulm I

Also relevant are the circumstances of the event (witnessed/unwitnessed), first-responder resuscitation efforts, the type of initial cardiac rhythm, the availability of automated external defibrillators, and the quality of the emergency medical services and subsequent medical care struc- tures (acute treatment, intensive care, rehabilitation).1 The interruption of the supply of oxygen to the brain. [...] Medical evaluation The medical evaluation of a CPR attempt, and the advice offered to the patient on this basis with regard to a CPR decision, needs to take into account not only psychosocial aspects and the current health status, but also the prognosis – par- ticularly for (largely) neurologically intact survival, or a quality of life acceptable to the patient – and a risk-benefit assessment. [...] On the basis of the medical evaluation, the opportunities and risks of a CPR at- tempt, and the prognosis, can be discussed with the patient. [...] For the patient and relatives, it can be reassuring to talk about what may happen in the last days and hours of life and to know that cardiac arrest is part of the normal process of dying.54 It should be explained that the patient will not be abandoned and that every effort will be made to relieve pain. [...] Documentation of the CPR decision in the patient’s records The CPR decision must be documented, with a brief statement of reasons, in the patient’s records.