• David Crosbie, Angaj Ghosh, Narkitaa Van Ekeren, Monica Dowling, Barbara Hayes, Anthony Cross, and Daryl Jones.
• Intensive Care Unit, Northern Health Epping, Melbourne, Victoria, Australia.
• Intern Med J. 2023 May 1; 53 (5): 798802798-802.

BackgroundThere is increasing recognition that a proportion of hospitalised patients receive non-beneficial resuscitation, with the potential to cause harm.AimTo describe the prevalence of non-beneficial resuscitation attempts in hospitalised patients and identify interventions that could be used to reduce these events.MethodsA retrospective analysis was conducted of all adult inhospital cardiac arrests (IHCA) receiving cardiopulmonary resuscitation (CPR) in a teaching hospital over 9 years. Demographics and arrest characteristics were obtained from a prospectively collected database. Non-beneficial CPR was defined as CPR being administered to patients who had a current not-for-resuscitation (NFR) order in place or who had a NFR order enacted on a previous hospital admission. Further antecedent factors and resuscitation characteristics were collected for these patients.ResultsThere were 257 IHCA, of which 115 (44.7%) occurred on general wards, with 19.8% of all patients surviving to discharge home. There were 39 (15.2%) instances of non-beneficial CPR, of which 28 (72%) of 39 occurred in unmonitored patients on the ward comprising nearly one-quarter (28/115) of all arrests in this patient group. A specialist had reviewed 30 (76.9%) of 39 of these patients, and 33.3% (13/39) had a medical emergency team (MET) review prior to their arrest.ConclusionsOver one in seven resuscitation attempts were non-beneficial. MET reviews and specialist ward rounds provide opportunities to improve the documentation and visibility of NFR status.© 2021 Royal Australasian College of Physicians.

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