Do-not-resuscitate orders in a childrenʼs hospital

OBJECTIVESa) To quantify the use of do-not-resuscitate orders in a tertiary care childrenʼs hospital; and b) to characterize the circumstances in which such orders are written. DESIGNRetrospective chart review. SETTINGUniversity teaching hospital. PATIENTSAll inpatients who died in an urban childrenʼs hospital over a 1-yr period of time. INTERVENTIONSNone. MEASUREMENTS AND MAIN RESULTSThe hospital records of 54 of 69 patients who died were reviewed. Eighty-two percent of patient deaths occurred in the ICU; 13% of patient deaths occurred in the operating room, and 5% occurred in a medical ward. Other findings included the following25 (46%) of 54 patients died after attempted cardiopulmonary resuscitation; 13 (24%) patients were brain dead; and 16 (30%) died with a do-not-resuscitate order in effect. Age was associated with resuscitation statusdo-not-resuscitate orders were written for five (21%) of 22 infants (