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Derek Kerr, MD
Fairmont Hospital San Leandro, Calif

JAMA. 1989;261(11):1582.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The thoughtful article by Dr Murphy¹ and the balancing editorial by Dr Youngner² on limiting cardiopulmonary resuscitation (CPR) in long-term—care institutions prompted a review of our own CPR experience in a 120-bed, hospital-based, skilled nursing facility. Our patients are characterized largely by multiple, severely disabling, chronic diseases or advanced cancer and other terminal conditions. Most require a level of nursing and medical care that is not available in community nursing homes.

In the 6-year period from July 1982 through June 1988, of 679 of our patients who died, 45 underwent CPR, for a CPR rate of 6.6%. During the first 2 years, the CPR rate averaged 14.5%, whereas in the last 2 it averaged 1.9%. This decline followed a previous CPR outcome study that showed the futility of CPR in severely debilitated patients. Since then, our medical staff has been more direct in counseling patients . . . [Full Text PDF of this Article]

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