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DNACPR information for patients and carers
CPR is first aid for when a heart stop unexpectedly. This page explains why some people may have a Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR).
When someone’s heart stops suddenly, we call this cardiac arrest. While the rest of their organs are all still working, then CPR started straight away gives them a chance to stay alive.
Without its oxygen supply, the brain will very quickly start to die. CPR keeps the blood circulating by repeated, high pressure compressions on the chest, that continue until the heart can be re-started, or until it is clear that the heart will not restart.
CPR may save a life and the healthiest people have around a 10% chance of surviving (slightly higher if they are already in hospital), although many won’t ever be well again.
If you were otherwise well, and then had a cardiac arrest, would you choose to have CPR? People who know how to do CPR will always start first (seconds matter, remember) and ask whether this person would want CPR later.
If someone doesn’t want CPR for any reason, then they have the right to refuse in advance. They can make an Advance Decision to Refuse Treatment (ADRT) but, for rapid advice in an emergency, their doctor needs to complete a Do Not Attempt CPR statement (DNACPR), which informs on your wishes and prevents CPR being commenced.
Having a DNACPR statement doesn’t change any other treatment options. People with DNACPR statements will still be offered treatments like intravenous drips, antibiotics, Intensive Care Unit care; if those options would be helpful for them.
Why do some people not want to receive CPR?
If CPR succeeds in restarting someone’s heart, they may not die but they may be permanently damaged. This includes brain damage. If you think you wouldn’t want to take the risk of surviving an unexpected cardiac arrest with very serious after effects, you may decide you wouldn’t want CPR to be started.
You’ve probably never even thought about that possibility. This is a chance to think about what matters most to you, and where CPR fits with your priorities.
If you wouldn’t want CPR, it’s your right to refuse it. But you won’t be able to refuse it at the point it might be needed, because you’ll be unconscious within seconds of your heart stopping. You need your doctor to provide a DNACPR statement to tell people not to start CPR.
When CPR is unlikely to succeed
Some conditions can make it very unlikely that CPR will help.
If someone has long-term organ damage and then they develop a sudden problem that stops their heart, it may be that their damaged organs can’t survive a cardiac arrest no matter how promptly CPR is started.
This applies to a variety of health conditions that many people already live with, even though they feel well enough from day to day.
For example, if someone has very weak bones, they could not survive the chest compressions of CPR. Or if someone’s heart or lungs are already weak from a long-term disorder, they may be damaged beyond repair during a cardiac arrest.
Could this situation apply to you? You would probably only know this if your doctor or nurse has discussed it with you. Your clinical specialist can tell you if your health problems make CPR unlikely to be an effective treatment for you.
People who are unlikely to be helped by CPR can be protected from it. A DNACPR statement can be made by your doctors if CPR would not help you. The doctor is obliged to tell you if a DNACPR statement is made for this reason, unless you say you don’t want to be told.
Every DNACPR decision must be weighed up carefully by the doctor, in discussion with the person if they want to be told. It must be a decision that respects the quality of life the person enjoys, regardless of any disability they currently live with. A DNACPR statement cannot be made for a group of people: every single person must be considered individually.
