Prospective Multi-centre Observational Study on the Epidemiology, Risk Factors and Consequences of Unexpected Cardiac Arrest in Intensive Care Units.
Conditions: Heart Arrest
Sponsor: Groupe Hospitalier de la Rochelle Ré Aunis

 
 
 
 
 
 
Unexpected Cardiac Arrest in Intensive Care Unit  
Prospective multi-centre observational study on the epidemiology, risk 
factors and consequences of unexpected cardiac arrest in intensive care 
units. 
 
Principal Investigator:  
Dr Maxime LELOUP,  
 
 Groupe Hospitalier de La Rochelle  Ré  Aunis  
 19 rue du Dr Schweitzer, 17000 La Rochelle 
 Tel : 05 46 45 66 09 
 Mail : maxime.leloup@chlarochelle.fr 
 
Coinvestigators : 
Groupe EPILAT 
Unité de recherche impliquée :  
EA 4569, Université Paris Descartes, Paris, France (Dr Olivier LESIEUR) 
 
Sponsor: 
Groupe Hospitalier de La Rochelle  Ré  Aunis 
19 rue du Dr Schweitzer 
17000 La Rochelle 
 
 
 

 
 
 
 
 
Version 01, 11/01/2016, ACIR 
 
Table of contents : 
 
1. Abstract 
 
2. Context 
 
3. Objectives  
3.1 Main objective 
3.2 Secondary objectives 
 
4. Methodology 
4.1 Inclusion criteria 
4.2 Noninclusion criteria 
4.3 Study Population  
4.4 Sample size 
 
5. Description of data collected 
 
6. Statistical Analysis  
 
7. Ethics 
 
8. References 
 

 
 
 
 
 
Version 01, 11/01/2016, ACIR 
1. Abstract 
 
1.1. Justification and objectives 
Unexpected cardiac arrest (UCA) occurs in 0.5 to 5 % of intensive care unit (ICU) 
admissions. Despite continuous monitoring and immediate advanced life support in 
situation of cardiac arrest administered in ICU, patients that often suffer from chronic 
or multisystem diseases have poor outcome after cardiopulmonary resuscitation. The 
etiologies of UCA occurring in ICU are rarely reported in the literature (never in 
France).The study aims at prospectively describing the epidemiology of unexpected 
cardiac arrest occurring in ICU. 
1.2. Studypatient characteristic 
 
Patients who suffer unexpected cardiac arrest during ICU stay and who undergo 
cardiopulmonary resuscitation (chest compression and/or external electrical shock). 
 
1.3. Study design 
This is a prospective multicenter cohort study covering one calendar year. For 
patients who suffer unexpected cardiac arrest, collecting epidemiological data, 
circumstances surrounding unexpected cardiac arrest, unexpected cardiac arrest 
characteristics, consequences of the unexpected cardiac arrest and patient outcome 
(patients alive at ICU and hospital discharge). 
1.4. Number of patients screened 
The results of a previous prospective study carried out by 43 French ICU, suggest 
that around 30 000 patients are expected to be screened in one calendar year in the 
participating ICU. Thanks to the incidence rate of unexpected cardiac arrest 
occurring in ICU reported in the literature, from 150 to 1500 may undergo an 
unexpected cardiac arrest. 
1.5. Main outcome mesure 
Incidence rate of unexpected cardiac arrest in participating ICU 
 
1.6. Results and expected contributions of the study 
The ACIR registry will allow identifying the warning signs preceding cardiac arrest 
and find measures to prevent their occurrence and/or limit their consequences. 
Based on the obtained results, recommendation proposals will be provided about 
development of safety culture, staff training, improvement of cardiopulmonary 
resuscitation quality and postresuscitation care, and effective use of a 
donotresuscitate policy. 
 

 
 
 
 
 
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2. Investigators 
3.1 Coordinator  
Dr. Maxime LELOUP, Service de Réanimation, Groupe Hospitalier de La Rochelle  
Ré  Aunis. 
 
3.2 Coinvestigators  
Name 
Town of Institution 
BEURET Pascal 
Roanne 
VAN DER LINDEN Thierry 
Lille  GHICL 
QUENOT JeanPierre 
Dijon 
BRUEL Cédric 
APHP  Hôpital Saint Joseph 
RIGAUD JeanPhilippe 
Dieppe 
THEVENIN Didier 
Lens 
THEVENIN Didier 
Arras 
ROBERT René 
Poitiers  Réanimation Médicale 
VIQUESNEL Gérald 
Caen – Réanimation Chirurgicale 
PICHON Nicolas 
Limoges 
WOLF Manuel 
Orléans – Réanimation Chirurgicale 
BLANC Pascal 
Pontoise 
AUSSEUR Antoine 
Cholet 
SEDILLOT Nicholas 
Bourg en Bresse 
FRANCONY Gilles 
Grenoble 
GONZALES Frédéric 
Avicenne 
SOLTANI Dhaoui 
Guéret 
CARIOU Alain 
APHP  Hôpital Cochin 
PICHOT Amélie 
Poitiers  Réanimation Chirurgicale 
KERFORNE Thomas 
Poitiers  Réanimation CardioThoracique 
LEGRIEL Stephane 
Versailles 
LESIEUR Olivier 
La Rochelle 
ANTOK Emmanuel 
Saint Pierre  La Réunion 
REIGNIER Jean 
Nantes 
LACHERADE Jean Claude 
La Roche sur Yon 
GONTIER Olivier 
Chartres 
SHIDASP Siami 
Sud Essonne 
AZOULAY Eli 
APHP  Hôpital Saint Louis 
TOUATI Samia 
Meaux 

 
 
 
 
 
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DJILLALI Annane 
Garches 
MORICONI Mikael 
Quimper 
FISCHER MarcOlivier 
Caen Réanimation CardioThoracique 
TAMION Fabienne 
Rouen 
ASFAR Pierre 
Angers 
DESACHY Arnaud 
Angoulême 
GELEE Bruno 
Beaumont 
TONNELIER JeanMarie  
Brest 
PLOUVIER Fabienne 
Agen 
FLOCCARD Bernard 
Lyon 
CHELLY Jonathan 
Melun 
 
 
3. Context 
Unexpected Cardiac Arrest in Resuscitation (ACIR) is a cardiocirculatory arrest that has led 
to at least one cardiopulmonary resuscitation technique (external cardiac massage, 
adrenaline and/or electric shock). They concern approximately 0.5 to 5% of the admissions in 
Resuscitation(1–14). Although they benefit from a technical environment conducive to 
prompt diagnosis and management, resuscitation patients suffer from chronic diseases and 
organ failure(s) that worsen the prognosis for CARI. The etiologies of ACIR are rarely 
described in the literature. (4,5,14). Their specificity lies in the fact that they can be linked to 
the medical characteristics of the patient, but also to the deleterious effects of the substitution 
techniques in place at the time of circulatory arrest (respiratory assistance, vasopressor 
drugs, extracorporeal circulation, etc.) (6,9,11,12,14). These same techniques can also 
reduce the effectiveness of cardiopulmonary resuscitation (cardiorespiratory interactions of 
respiratory assistance, proarrhythmogenic effect of vasopressor drugs, hemodynamic 
repercussions of extracorporeal circulation). Although there are many publications on extra 
or intrahospital cardiac arrest, few studies specifically concern ACIR (none in France). 
However, the prognosis is different: after an ACIR, 50% of patients recover spontaneous 
cardiac activity but only 15% leave hospital alive (3 to 4% with good functional autonomy) 
(14). A prospective description of risk factors, circumstances and mediumterm consequences 
would help identify (and prevent) risk situations and distinguish among patients at risk for 
CAIR those for whom PCR is warranted. 
 

 
 
 
 
 
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4. Objectives  
 
4.1. Main objective 
Describe the epidemiology of unexpected cardiac arrest in Resuscitation (ACIR). 
 
4.2. Secondary Objectives 
 
 
Investigate the predictive and prognostic factors of unexpected cardiac arrest; 
 
 
Describe the etiologies of unexpected cardiac arrest; 
 
 
Observe the fate of patients suffering from unexpected cardiac arrest at 24 hours, at 
the end of resuscitation, at hospital discharge and 6 months after ACIR ; 
 
 
Describe the proportion of patients with unexpected cardiac arrest who have not been 
resuscitated without a previous DNR order; 
 
 
Describe the proportion of patients with unexpected cardiac arrest who were 
resuscitated despite a previous DNR order. 
 
 

 
 
 
 
 
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5. Methodology 
This is a 12month prospective multicentre observational study.  
It will be carried out by the "EPILAT" group, which has already worked and published on the 
epidemiology of therapeutic limitation measurements in intensive care units in France. 
(15,16). 
The data will be collected on a computerized register, carried out according to the 
recommendations of the UtsteinStyle (17).  
5.1. Inclusion criteria 
 
 
Age over 18  
 
Patient with unexpected cardiac arrest during his / her hospitalization in the ICU 
 
Patients who have benefited from at least one basic cardiopulmonary resuscitation 
technique by the ICU team to treat this circulatory arrest (external electric shock, 
external cardiac massage, adrenaline injection ...) 
 
Patients with multiple unexpected cardiac arrest during hospitalization will be included 
only for the first circulatory arrest. 
 
5.2. Non inclusion criteria 
 
 
Patients with unexpected cardiac that have not been resuscitated. 
 
Patients in cardiac arrest at admission to ICU 
 
5.3. Study population 
The study period is 12 months. Included are patients admitted to Resuscitation during the 
study period with ACIR.  
Patients included will be followed until discharge from Resuscitation/Hospital or until death. 
For patients alive at discharge, a neurological assessment will be performed according to the 
cerebral performance categories (CPC) scale before discharge and at 6 months (18). 
5.4. Sample size 
A recent prospective multicenter study conducted in 43 ICU departments over a period of 60 
to 90 days included 5,589 patients. (15,16). The prevalence of ACIR in resuscitation patients 
being between 0.5 and 5% in the literature (1–14), a 2month observation period over the 
same number of centres would allow the analysis of between 150 and 1500 ACIRs. It should 
be noted that in the study by the EPILAT group (15,16), 8% of the patients admitted were 
reported to have died of ACIR, resuscitated or not. To explain this difference, our hypothesis 
is that a large number of circulatory arrests, described as unexpected but highly predictable 
given the seriousness of the patient, occur outside any context of therapeutic limitation, 
without any resuscitation measures being taken. The ACIR for which no resuscitation 
measures are undertaken given the severity of the patient will therefore not be included in 
the study. 

 
 
 
 
 
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6. Description of data collected 
Data for the participating centres in the study will be collected on an "ACIR Centre" form: 
 
 The name of the centre 
 
 The academic or nonacademic character of the institution (CHU, CHR, CHG, PSPH) 
 
 The type of resuscitation (multipurpose, surgical, medical, neurosurgical) 
 
 The number of resuscitation beds 
 
 FDI/patient ratio 
 
 Whether or not to organise CPR training for all staff 
 
 The frequency of these training courses if they are offered 
 
 The practice of simulation workshops by physicians and/or staff. 
A count of all inpatients in the ICU during the study period will be conducted in each centre. 
This census will include : 
 
 Initials of patient's first and last name 
 
 Date of Birth 
 
 Patient's gender 
 
 IGS II 
 
 Main diagnosis (medical, scheduled surgery, emergency surgery) 
 
 Length of stay 
 
 Lively exit from the service 
 
 For patients who died in resuscitation: death by brain death, ACIR or predictable 
cardiac arrest  
A screening will be completed for all patients with circulatory failure in the department during 
the study period. The study will collect the following information: 
 
 Initials of the patient's first and last name 
 
 Month and year of birth 
 
 Date of circulatory stop 
 
 Date of admission to Resuscitation 
 
 Reason for admission to Intensive Care Unit (Medical, Scheduled Surgical, Urgent 
Surgical) 
 
 Score IGS 2 
 
 Carrying out resuscitation or non resuscitation maneuvers 
 
 If not, reason for nonresurrection: 
o prior decision of limitation or therapeutic discontinuation 
o Nonresponse to maximum treatment 
o Other reason to be specified 
 
 

 
 
 
 
 
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When the patient will benefit from resuscitation maneuvers (external cardiac massage, 
external electric shock, adrenaline...), he will be included in the study and the data will be 
collected in the observation notebook "Data on ACIR": 
1- Hospitalization in intensive care 
a. Reason for admission 
b. Mc Cabe score (20) 
c. Knaus score (21) 
 
2- Patient history and co-morbidities 
a. 
Diabetes 
b. 
High blood pressure 
c. 
Smoking 
d. 
Chronic Ethylism 
e. 
Dyslipidemia 
f. 
Coronary artery disease  
g. 
Chronic Respiratory Failure 
h. 
Chronic heart failure 
i. 
Chronic renal failure 
j. 
Chronic Liver Failure 
k. 
Chronic neurological pathology 
l. 
Cancer, haematological malignancies  
m. 
Cardiac arrest successfully resuscitated prior to this hospitalization 
 
3- Patient organ failures at the time of cardiac arrest 
SOFA score (22) 
Patients will be considered deficient when the SOFA score is greater than or equal to 
3 on the organ concerned.  
 
 
4- Had the patient already been the subject of a decision to limit or stop therapy prior to 
unexpected cardiac arrest? 
 
 
5- Treatments in place at the time of occurrence the unexpected cardiac arrest 
 
a. Non-ventilated patient without tracheal approach 
b. Non-ventilated tracheostomy patient 
c. High-flow oxygenation device 
d. Intermittent or continuous non-invasive ventilation 
e. Invasive intubation catheter ventilation 
f. Invasive tracheostomy ventilation 
g. Sedation  
h. Catecholamines 
i. 
Extra-renal purification  
j. 
Other  
 

 
 
 
 
 
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6- The last constants noted on the monitoring before the unexpected cardiac arrest 
a. 
Time of recording 
b. 
Level of awareness 
c. 
Blood pressure monitoring 
d. 
Blood pressure 
e. 
Heart rate 
f. 
Oxygen saturation 
g. 
Temperature 
 
7- Date and time of occurrence of the unexpected cardiac arrest 
 
8- The activity of the service on the day of the occurrence of the unexpected cardiac 
arrest according to the resuscitator 
 
9- The bed occupancy rate at the time of the unexpected cardiac arrest 
 
10- The Special Circumstances at the Occurrence of the unexpected cardiac arrest 
a. 
Patient in bed with no special circumstances 
b. 
Patient in prone position 
c. 
Chair Patient 
d. 
During an intra-hospital transfer 
e. 
During an extra renal cleansing session 
f. 
During a disconnection session (T-piece) 
g. 
During a non-invasive ventilation (NIV) session 
h. 
During an intubation 
i. 
During central venous line placement 
j. 
During a bronchial fibroscopy 
k. 
During a transfusion of labile blood products 
l. 
During a diaper change, nursing care 
m. 
Subsequent to the administration of a medicament 
n. 
During another risky procedure 
 
 
11- Data specific to Cardiopulmonary Resuscitation 
a. CPR start time 
b. Initial heart rate (FV/TV, Pulseless electrical activity, asystole) 
c. External electric shock (time of first, number of shocks) 
d. External cardiac massage (start time, total duration of massage) 
e. Intubation (time of intubation) 
f. Injections :  
i. Adrénaline (heure de première injection, dose totale) 
ii. Other (Amiodarone, fibrinolysis, atropine, isoprenaline, others) 
g. Volumetric expansion (total volume) 
h. Transfusion (number of red blood cells) 
i. 
Other (depending on the circumstances of occurrence) 
 

 
 
 
 
 
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12- Monitoring during CPR 
a. 
Bloody pressure 
b. 
Capnometry 
c. 
Pulse oximetry 
d. 
Electrocardioscope 
e. 
Transthoracic ultrasound 
f. 
Other 
 
13- The identified etiologies of the unexpected cardiac arrest 
a. Related to means of substitution 
i. Respiratory 
1. Respirator abnormality 
2. Pipe anomaly 
3. Accidental Extubation 
4. Intubation tube obstruction 
5. Other 
ii. Circulatory 
1. Failure to infuse catecholamines 
2. Accident during an extrarenal purification or extracorporeal 
circulation (if yes continuation of extrarenal purification?) 
3. Error in drug, ion or toxin administration 
4. Drug overdose 
5. Other 
b. Patient-related 
i. Hypothermia 
ii. Hypoxia 
iii. Hypovolemia 
iv. Hemorrhage 
v. Metabolic (dyskalemia, dyscalcemia...) 
vi. Acute coronary syndrome 
vii. Pulmonary embolism 
viii. Pneumothorax 
ix. Tamponnade 
x. Other 
 
14-  Complementary examinations carried out at the immediate disbursement of the 
unexpected cardiac arrest 
a. Standard Life Cycle Assessment 
b. Chest X-ray 
c. Transthoracic echocardiography 
d. eFast echo 
e. Coronary angiography 
f. Brain scan 
g. Other 
 

 
 
 
 
 
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15- Cessation of CPR  
a. Recovery of spontaneous cardiac activity (RACS) and time of RACS 
b. CPR failure and patient death (time of death) 
 
16-  For patients who have resumed spontaneous cardiac activity (RACS) 
a. Therapeutic measures carried out during the course of the unexpected 
cardiac arrest 
i. Thermal control (32 - 36°C)  
ii. AOHC Prevention 
iii. Emergency surgery 
iv. Thoracic drainage 
v. Pericardial drainage 
vi. Angioplasty 
vii. Transfusion 
viii. Vascular filling 
ix. Extra renal purification 
x. Reintubation 
xi. Bronchial fibroscopy 
xii. Electrosystolic drive 
xiii. Other 
 
b. Tests performed to assess post-unexpected cardiac arrest neurological 
prognosis 
i. Clinical Examination: Glasgow score, encephalopathy (convulsions, 
abnormal movements), trunk reflexes 
ii. Electroencephalogram (Burst suppression, epileptiform discharges, 
poor EEG activity) 
iii. Determination of the NSE (with the day of sampling and its value) 
iv. Somatosensory evoked potentials (presence of an N20 wave) 
v. Brain MRI (Normal or abnormal) 
vi. Other 
 
c. Patient outcome 
i. For patients who died in intensive care 
1. The date of death 
2. The method of death certification (brain, circulatory) 
3. Has it been the subject of a multi-organ harvesting procedure? 
4. Has it been the subject of Limitation or discontinuation of 
therapy after the onset of unexpected cardiac arrest? 
 
ii. For patients discharged alive from resuscitation  
1. The date of resuscitation release 
2. The Cerebral performance category scale (CPC) score at the 
exit of resuscitation. 
3. Date of discharge from hospital 
4. Did the patient leave the hospital alive or dead? 

 
 
 
 
 
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5. Is the patient alive or dead 6 months after the onset of CARI? If 
alive, what is the Cerebral performance category scale (CPC) 
score at 6 months? 
 
17- Risk prevention policy: has the unexpected cardiac arrest resulted in 
a. A serious adverse event report? 
b. A morbidity and mortality review? 
c. A material vigilance report? 
d. A pharmacovigilance declaration? 
e. A haemovigilance declaration? 
f. A drug dosage? 
g. Allergic explorations? 
h. A change in service practices (if yes, which ones?)? 
The computerized data will be recorded on the eCRF managed by the Medsharing company. 
They will then be used on Dr LELOUP's computer thanks to EPIINFO and R software. They 
will be consulted exclusively by Dr LELOUP and Mrs Alice LANGLOIS, Clinical Research 
Associate. 
6. Statistical analysis 
 
Statistical analyses will be carried out using EPIINFO and R software.  
Quantitative variables will be expressed as means (+/ standard deviation) or medians and 
quartiles depending on the size and distribution of the workforce. These variables will be 
compared using Student's tests or Mann Witney Wilcoxon tests. 
Qualitative variables will be expressed as absolute values and percentages. They will be 
compared by Chisquare tests or exact FISCHER tests. 
Differences will be estimated to be significant when the p is less than 0.05. 
If possible, multivariate analyses will be carried out using a stepwise logistic regression. The 
variables included will be those whose comparison obtained a p of less than 0.2 in univariate 
analysis. 
Missing or lost data will not be included in the statistical analysis. 

 
 
 
 
 
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7. Ethics 
 
This work received a favourable opinion from the Advisory Committee on Information 
Processing in Health Research on 9 July 2015 (Dossier n°15.487). 
It received a favourable opinion from the Commission Nationale de l'Informatique et des 
Libertés on 25 February 2016. 
It received a favourable opinion from the Comité de Protection des Personnes Ile de France 
II on 11 January 2016 (IRB registration: 00001072). 
In view of the epidemiological nature of the collection, an information letter will be given to 
the patient's relatives, who are free to accept or refuse the patient's inclusion in the register 
(Annexe 1).  
The patient, once again competent and able to receive the information, will be able to accept 
or refuse his or her own entry in the register (Annexe 2). 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
 
 
 
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Lee HK, Lee H, No JM, Jeon YT, Hwang JW, Lim YJ, et al. Factors influencing 
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McCabe W. GramNegative Bacteremia: I. Etiology and Ecology. Arch Intern Med. déc 
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intensive care setting. Arch Intern Med. nov 1992;152(11):2305‑8.  
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of critically ill patients who received cardiopulmonary resuscitation. Am J Respir Crit 
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Ann Intensive Care. déc 2015;5(1):56.  
 
 
 

 
 
 
 
 
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ANNEXE 1 
 
 
 
Dear Madam, dear sir, 
 
One of your family members hospitalized in Resuscitation at the hospital center of 
…………………………………………. has just suffered a cardiac arrest and was subjected to 
cardiopulmonary resuscitation. 
 
Unexpected cardiac arrest is a rare but serious event that can occur in Resuscitation despite the 
monitoring and back-up techniques in place. As part of a research project involving many French 
hospitals, we are currently studying the incidence, circumstances and consequences of such an event. 
The final objective of this work is to propose practical measures to prevent the occurrence of 
unexpected cardiac arrest in intensive care or to reduce the consequences as much as possible. 
 
In order to optimize the care of our patients, a certain amount of medical information is collected and 
recorded at the hospital on a computer server: history, previous hospitalizations, history of the disease, 
possible allergies, clinical examination, biological examinations, medical imaging, specialized opinions, 
report of additional examinations or interventions, discharge letter, etc. Thanks to a secure access 
system, this confidential information can only be consulted by the health professionals concerned. The 
computerization of the data collected is intended to facilitate the transmission of useful information and 
to ensure its traceability, including in the event of new hospitalization. 
 
It is also possible to make this data anonymous, to group and analyse it collectively in order to assess 
the quality of our practices a posteriori. Indeed, it is by multiplying the number of observations that 
medical knowledge progresses. These so-called "epidemiological" or "non-interventional" studies also 
make it possible to determine the means necessary for the proper functioning of our services. French 
and European regulations stipulate that hospitalized patients may object to any present or future use of 
data concerning them, even if it does not allow them to be identified. If the patient is unable to express 
his or her choices, relatives are asked to testify to any opposition to this type of research. 
 
Expressed directly or through relatives, individual preferences in terms of epidemiological research in no 
way influence the quality of care provided to the patient and the vigilance of caregivers in their hospital 
missions. Doctor……………………………………… (Telephone………………….), more particularly in 
charge of the study on unexpected cardiac arrest, is at your disposal for any information concerning this 
research protocol. 
 
 
 
 
 
 

 
 
 
 
 
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ANNEXE 2 
 
 
Dear Madam, dear sir, 
 
You are (or have been) hospitalized in Resuscitation at the hospital center of …………………. 
 
To improve your care, a certain amount of personal information is collected and recorded on a computer 
server: history, previous hospitalizations, history of the disease, possible allergies, clinical examination, 
biological examinations, medical imaging, specialized opinions, reports of additional examinations or 
interventions, discharge letter, etc. Thanks to a secure access system, this confidential information can 
only be consulted by the health professionals directly involved in your care. The computerization of the 
data collected is intended to facilitate the transmission of useful information and to ensure its 
traceability, including in the event of new hospitalization. 
 
It is also possible to anonymize this data, to aggregate and analyze it collectively in order to evaluate 
the quality of our practices a posteriori. It is indeed by multiplying the number of observations that 
medical knowledge progresses. These so-called "epidemiological" or "non-interventional" studies also 
make it possible to determine the means necessary for the proper functioning of our services. 
 
Unexpected cardiac arrest is a rare but very serious event that can occur in Resuscitation despite the 
monitoring and replacement techniques in place. As part of a research project involving several 
hospitals, we are currently studying the incidence, circumstances of occurrence and consequences of 
such an event. The final objective of this work is to propose practical measures to prevent the 
occurrence of unexpected cardiac arrest in the ICU or to reduce its consequences as much as possible. 
You yourself have suffered a cardiac arrest during your stay in Resuscitation. Your relatives have not 
expressed any objection to the collection of information about you, until you yourself are able to give 
your opinion on this study. 
 
French and European regulations stipulate that you may oppose any present or future use of data 
concerning you, even if they do not allow you to be identified. All you have to do is explicitly indicate this 
when you are hospitalized, or through a relative. You do not have to justify the reasons for this 
opposition, which may be expressed orally or in writing. Your decision obviously has no impact on the 
quality of the care you will receive. If you do not object to the use of your anonymous medical data, you 
are fully entitled to know the results of the study and the practical measures that will be taken as a result 
at a later date. 
 
During your stay and on the way out, you may at any time specify, modify or cancel any directives 
concerning you. As guarantors of your freedom of choice, the carers around you have a duty to listen to 
your wishes and to testify to them if necessary. Do not hesitate to ask them for more information. In 
Resuscitation, Doctor ………………………………………….. (Phone………………………..) is more 
particularly in charge of the study on unexpected cardiac arrest and is at your disposal for any further 
information.