Moving to High-Value Care: More Thoughtful Use of Cardiopulmonary Resuscitation
Authors: Frank H. Bosch, David A. Fleming
Journal: Annals of Internal Medicine (2015)

Ideas and Opinions2 June 2015Moving to High-Value Care: More Thoughtful Use of Cardiopulmonary ResuscitationFrank H. Bosch, MD, PhD and David A. Fleming, MD, MAFrank H. Bosch, MD, PhDFrom Rijnstate Hospital, Arnhem, the Netherlands, and University of Missouri School of Medicine, Columbia, Missouri.Search for more papers by this author and David A. Fleming, MD, MAFrom Rijnstate Hospital, Arnhem, the Netherlands, and University of Missouri School of Medicine, Columbia, Missouri.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-0492 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Since Safar and colleagues first described mouth-to-mouth ventilation in 1958 (1) and Kouwenhoven and colleagues described closed-chest cardiac massage in 1960 (2), many changes in technique and protocol have improved outcomes of cardiopulmonary resuscitation (CPR) (3). All hospitals have a CPR team in place, and automated external defibrillators (AEDs) are omnipresent in public spaces in the developed world. Often a dramatic event within health care settings, CPR has been further dramatized in movies and television shows.In real life, physicians perform this ritual in hospitals repeatedly and reflexively. Too often we perform it regardless of prognosis, without knowing whether the ...References1. Safar P, Escarraga LA, Elam JO. A comparison of the mouth-to-mouth and mouth-to-airway methods of artificial respiration with the chest-pressure arm-lift methods. N Engl J Med. 1958;258:671-7. [PMID: 13526920] CrossrefMedlineGoogle Scholar2. Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. JAMA. 1960;173:1064-7. [PMID: 14411374] CrossrefMedlineGoogle Scholar3. Chan PS, McNally B, Tang F, Kellermann A; CARES Surveillance Group. Recent trends in survival from out-of-hospital cardiac arrest in the United States. Circulation. 2014;130:1876-82. [PMID: 25399396] doi:10.1161/CIRCULATIONAHA.114.009711 CrossrefMedlineGoogle Scholar4. Girotra S, Nallamothu BK, Spertus JA, Li Y, Krumholz HM, Chan PS; American Heart Association Get with the Guidelines Resuscitation Investigators. Trends in survival after in-hospital cardiac arrest. N Engl J Med. 2012;367:1912-20. [PMID: 23150959] doi:10.1056/NEJMoa1109148 CrossrefMedlineGoogle Scholar5. Alahmar AE, Nelson CP, Snell KI, Yuyun MF, Musameh MD, Timmis A, et al. Resuscitated cardiac arrest and prognosis following myocardial infarction. Heart. 2014;100:1125-32. [PMID: 24763491] doi:10.1136/heartjnl-2014-305696 CrossrefMedlineGoogle Scholar6. Stapleton RD, Ehlenbach WJ, Deyo RA, Curtis JR. Long-term outcomes after in-hospital CPR in older adults with chronic illness. Chest. 2014;146:1214-25. [PMID: 25086252] doi:10.1378/chest.13-2110 CrossrefMedlineGoogle Scholar7. Institute of Medicine. Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. Washington, DC: National Academies Pr; 2014. Google Scholar8. Pizzo PA. The Doctor: for life and at the end of life. Ann Intern Med. 2015;162:228-9. [PMID: 25486216] doi:10.7326/M14-2399 LinkGoogle Scholar9. Green MJ, Rieck R. Annals Graphic Medicine: Betty P. Ann Intern Med. 2015;162:W74-9. [PMID: 25845018] doi:10.7326/G14-0009 LinkGoogle Scholar10. Smith CD; Alliance for Academic Internal Medicine–American College of Physicians High Value, Cost-Conscious Care Curriculum Development Committee. Teaching high-value, cost-conscious care to residents: the Alliance for Academic Internal Medicine–American College of Physicians curriculum. Ann Intern Med. 2012;157:284-6. [PMID: 22777503] doi:10.7326/0003-4819-157-4-201208210-00496 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Rijnstate Hospital, Arnhem, the Netherlands, and University of Missouri School of Medicine, Columbia, Missouri.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-0492.Corresponding Author: Frank H. Bosch, MD, PhD, Rijnstate Hospital, Department of Internal Medicine, PO Box 9555, 6800 TA Arnhem, the Netherlands; e-mail, [email protected]com.Current Author Addresses: Dr. Bosch: Rijnstate Hospital, Department of Internal Medicine, PO Box 9555, 6800 TA Arnhem, the Netherlands.Dr. Fleming: University of Missouri School of Medicine, MA412 Medical Science Building, 1 Hospital Drive, Columbia, MO 65212.Author Contributions: Conception and design: F.H. Bosch.Drafting of the article: F.H. Bosch, D.A. Fleming.Critical revision for important intellectual content: F.H. Bosch, D.A. Fleming.Final approval of the article: F.H. Bosch, D.A. Fleming. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals Graphic Medicine - Betty P. Michael J. Green and Ray Rieck Annals Graphic Medicine - Betty P. Michael J. Green and Ray Rieck Metrics 2 June 2015Volume 162, Issue 11Page: 790-791KeywordsFearHealth careHeartHospital medicineHospitalizationsPatientsResuscitationVital signs ePublished: 2 June 2015 Issue Published: 2 June 2015 CopyrightCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...