Apr 222011

Interviewing 100 patients or their surrogates in the ICU, 85% of whom were "full code," Gehlbach et al found 16% of patients' code status in the chart did not correlate with their expressed preferences during the interview (10 wanted less care, 6 wanted more). Respondents' average prediction for their survival should they have a cardiac arrest: 72%. Only 4% could identify the 3 components of CPR (intubation, compressions, shocks). After learning of the evidence-based estimates of likelihood of survival and neurologic outcome, only about 10% (8 patients) felt less eager to get full-bore CPR than they were initially. CHEST 2011;139:802-809.

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Code status & patient expectations — reality disconnect