ReSPECT

ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment.

What matters to you is important to us. Knowing this helps us to plan your care if you experience a medical emergency.

This page offers some general information about:

What the ReSPECT process is
What CPR is, what it can and can’t do
Why it is important to talk emergency care planning and CPR

Further down this page you will find an FAQ (Frequently Asked Questions) and links to resources that tell you more about ReSPECT. These have been designed by the Resuscitation Council (UK) and are available as text in English, Easy Read and video formats, and in Urdu, Polish, Punjabi, Chinese, Gujarati, Arabic and Turkish.

If you would like to have a ReSPECT conversation at any time, please ask your healthcare team.

Thinking about your future care, including Cardiopulmonary Resuscitation (CPR) is a good thing for everyone to do but it can feel upsetting. We suggest you take your time when reading this web page. You might want to read a bit, have a break and then read some more, or come back to it another day. You might like to ask someone to read it with you so that you can talk about it together.

The ReSPECT process empowers you to guide healthcare teams in hospital and the community about the treatments you would or would not want to be considered for. The plan you make together can record treatments that could be important and / or those that would not work for you.

What is the ReSPECT process?

The ReSPECT process consists of one or more conversations between you and your healthcare professionals. Together you decide which types of care and treatment you would or would not want to be considered for in an emergency.

Treatments that can be life-sustaining for some people carry a risk of causing harm, discomfort or loss of dignity for others. Many people choose not to accept that risk if the treatment benefit is small. Your ReSPECT plan records your preferences and the agreed realistic recommendations for emergency situations, whatever stage of life you are at.

The agreed plan is recorded in a ReSPECT document. The plan will be put into your medical notes while you are in hospital and given to you to keep when you are discharged. It is important that you keep this document in a safe place at home where you or someone else can find it in a medical emergency. Please make sure that all healthcare professionals called to help you in an emergency are given your ReSPECT document to read. This will help you to be given the care recommended on your plan

How does the ReSPECT process work?

The first step of ReSPECT process is a conversation between you and one or more health professionals involved in your care. This leads to a plan being made and written in a ReSPECT document. You can choose to include your family, friends and or carer(s) in these discussions.

What is a ReSPECT conversation about?

ü ReSPECT conversations are about coming to a shared agreement of your health and care needs and the ways these could change in an emergency.

ü Your preferences for your future care and treatment in an emergency form the next part of the discussion.

ü This is followed by agreeing and recording recommendations that are realistic and could help you to be cared for in the way that you wish.

ü The conversation will also involve a discussion about cardiopulmonary resuscitation (CPR) and whether this would or would not be of benefit given your health conditions.

The ReSPECT process is intended to respect both patient preferences and clinical judgement. It is important to understand that the ReSPECT plan cannot be used to demand treatments that are not likely to benefit you and would not be offered.

Sometimes conversations like these can make us think about our future or the future of our loved ones. While this can make us feel sad, knowing that a plan has been made can help to ease our worries.

Once a plan has been made we will put a copy of it in your medical notes so that we can use it while you are in hospital. The original plan will be given to you to take home so that it will be available to any health and care professional who needs to understand your wishes. We will also inform your GP that we have written a ReSPECT plan.

Why do you talk about CPR in a ReSPECT conversation?

A ReSPECT plan includes a section about CPR. After a full discussion with you, the plan will say either CPR attempts are recommended, or CPR attempts are not recommended.

As CPR forms part of the ReSPECT plan it is important that we help you to understand about CPR. You will then be better able to discuss CPR with your healthcare team.

CPR stands for cardiopulmonary resuscitation. This emergency procedure tries to restart someone’s heart and or breathing if they stop.

The heart and breathing can stop for many different reasons. This is why CPR helps some people but not others. CPR does not treat the problem that caused the heart or breathing to stop, but sometimes CPR can restart the heart and breathing so that other treatment can be given.

CPR is usually for emergency situations rather than when the heart and breathing stop in natural, ordinary dying. The end of life, when the organs of our body fail through illness, injury or age, it a time to focus on comfort, dignity and loved ones.

What happens in CPR?

In CPR a person’s chest is pressed hard and repeatedly. Medication is given through a vein and the person is helped to breathe by a mask or tube. An electric shock might be given to the heart.

What happens after CPR?

If CPR restarts the heart and breathing, some people return to being how they were before. They are often unwell for a while and may need further treatment. Other people are left less well after CPR or with long term damage, sometimes to the brain.

23.6% of people who receive CPR in hospital survive to go home. These are often people who have been injured or were acutely unwell for a reason that could be treated.