CPR away from the hospital

When you leave your ward for tests or scans in a different part of the hospital, your medical notes should be with you. If you have chosen not to have CPR, there will be a note on your medical records so that staff across the whole hospital know.

If you are at home when you have a cardiac or respiratory arrest, it is likely that a 999 call will be made. If you have made a decision not to have CPR this should have been communicated to your GP, the local out-of-hours service and the ambulance service. You can ask to keep a copy of any relevant documents to have at home.

If you change your mind about CPR you should let your healthcare team know as soon as possible. If they agree with your decision they will make the change to your medical notes.

Some people make a choice about CPR some time before it is needed. There is a special document that you can fill out if you wish to do this. It is known as an advance decision to refuse treatment.

Whatever your decision on CPR, this will not affect the rest of your treatment or care.

What if a cardiac or respiratory arrest happens when I'm not on the hospital ward?

If a person leaves the hospital ward, for example for an x-ray, they’ll usually take their medical notes with them. Many hospitals have a system whereby a sticker on the outside of the medical notes indicates that CPR should not be attempted. This is to ensure that all healthcare professionals are aware of the person's resuscitation status.

As well as the sticker system, hospitals aim to have good communication so that staff in other departments are aware if CPR is not to be attempted. This covers the situation where a person leaves the ward but doesn't have their notes with them.

What happens when I'm at home?

A person may wish to discuss their concerns about CPR before they are discharged from hospital. It's important to bear in mind that in the community there is no specialist team or equipment at hand should a cardiopulmonary arrest happen. In that situation, a 999 call would be made. 

Many GPs and community palliative care teams will routinely discuss CPR with their patients and families, especially if your condition begins to change or worsen. Any decision you make about whether or not you would like CPR to be attempted will be communicated to all the relevant members of your community team, including your local out-of-hours service and the ambulance service. This can help prevent unwanted attempts at CPR, which can be very distressing. 

Whoever discusses CPR with you should tell you how your decision will be communicated to the people who need to know. You can also ask for a copy of the documentation, for your family or carers to have at home. 

If it has been decided that CPR shouldn't be tried for someone and an ambulance is called for them, the ambulance crew will always attempt CPR unless there’s clear documentation stating the 'do not attempt resuscitation' order.

What happens if I change my mind about CPR?

You can change your mind about CPR at any time. If you do, it’s important to tell a member of your healthcare team. If you make a new decision with your healthcare team, they will record it in your medical notes. Remember to tell your family or carer about any changes to avoid confusion.

An advance decision to refuse treatment

Some people with cancer may wish to make a choice about whether they want CPR to be attempted in the months or years ahead. If they choose not to have CPR attempted, they can record this using an advanced decision to refuse treatment document (known as an advance decision or advance directive in Scotland). This means that, should the situation ever arise, healthcare professionals and family and friends will know what the person’s wishes are. A copy of the advance decision to refuse treatment can be put into the person's medical notes.

You can ask your specialist nurse or doctor for more information about this.

Will a decision about CPR affect the rest of my treatment or care?

A decision about CPR will not affect any other care or treatment that you get.

Each time you are admitted to hospital, a doctor will check the CPR decision and discuss it with you. This is important because your medical condition or decision may change.

Back to Coping with advanced cancer

Decisions about treatment

You may have lots of questions about your treatment options. You can talk to your doctors and nurses about these.

Who can help?

You can get care and support at home, in a hospital or in a hospice. This depends on your needs and preferences.

What is CPR?

Cardiopulmonary resuscitation (CPR) can be used to try to restart the heart and breathing if they have stopped.

Making CPR decisions

You may be asked to make a decision with your family and healthcare team about whether you want cardiopulmonary resuscitation (CPR) to be attempted.