Cardiopulmonary resuscitation of the elderly

Cardiopulmonary resuscitation (CPR) has been practiced since 1960. In mixed-age populations there is about a 10 per cent survival rate. Most CPR studies state that "age alone" is not a critical factor in survival. Studies that focus specifically on the elderly suggest that although "age alone" is not a critical survival factor, previous level of function and severity of underlying disease have major effects on CPR outcome. In most medical institutions CPR is undertaken unless a specific "do not resuscitate" order is written. Many impaired and chronically ill elderly therefore undergo unnecessary and unsuccessful CPR. The available data suggest that CPR is suitable for the independent and relatively well elderly to whom CPR measures can be quickly applied. For the chronically dependent and ill elderly, CPR in most instances should not be undertaken. Such an eventuality, however, should be anticipated and whenever possible discussed with patients and family members, thus allowing decisions to be made consciously rather than leaving them "to chance."