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A UK National Health Service (NHS) trust implemented a blanket “do-not-resuscitate” order for patients during the Covid pandemic, according to former Resuscitation Council UK president, Prof Jonathan Wyllie. The order, which means individuals are considered ineligible for potentially life-saving cardiopulmonary resuscitation (CPR) solely due to their age or disability, was applied without individual assessment. While Wyllie said he knew of one trust implementing the policy, he had not seen a document setting it out.
NHS guidance allows a Do Not Attempt Cardiopulmonary Resuscitation (DNCPR) order to be added to medical notes after consultation with the patient or their family. It means medical professionals will not attempt chest compressions or defibrillation for patients that stop breathing or whose heart stops. According to NHS England, a blanket DNACPR rule for every person with a specific medical condition or aged over a certain threshold would be illegal.
Groups representing the families of people who died from Covid believe blanket DNACPR orders were applied at some NHS departments during the pandemic, based only on age, disability, or medical condition. At the time, the charity Mencap reported that people with learning disabilities had been informed they would not receive resuscitation if ill with Covid. NHS England has emailed NHS trusts on multiple occasions during the pandemic to remind medical professionals that orders should only be applied with “appropriate consent”.
Covid-19 Bereaved Families for Justice UK said the use of blanket policies would provide “irrefutable evidence” that NHS services had been overwhelmed. According to the group’s solicitor Nicola Brook, “The bereaved families have known for a long time that the realities on the ground were very different. Their worst fears have now been confirmed but this brings with it more questions, ‘If it happened at this trust, did it happen at the trust where my loved one was?'” Only 15-20% of people receiving CPR in a hospital setting survive, with success rates dropping to 5-10% outside of hospitals
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