Scott D. Halpern, MD, PhD; Ezekiel J. Emanuel, MD, PhD
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=M14-2611.
Halpern S., Emanuel E.; Use of Life-Sustaining Therapies for Patients With Ebola Virus Disease. Ann Intern Med. 2015;163:70. doi: 10.7326/L15-5106-2
Download citation file:
Published: Ann Intern Med. 2015;163(1):70.
We appreciate Dr. Berger's interest in our commentary, but his argument is based on inaccurate information. It is true that attempting CPR is the “default” policy in contemporary practice. However, among all patients who do not opt out of this default and who experience in-hospital sudden cardiac arrest, survival to hospital discharge is now 15% (1). Furthermore, time is of the essence. For example, among patients with shockable rhythms (ventricular fibrillation or tachycardia), resuscitation within 2 minutes leads to nearly twice the survival rate as resuscitation after 2 minutes (2). Thus, the need to first don personal protective equipment in the case of Ebola—which requires at least 10 minutes among even experienced practitioners—means that CPR in this setting confers a fundamentally different prognosis from CPR in patients who do not have Ebola. As such, using the same weighing of benefits to the patient versus risks to the clinician that both Berger and we advocate yields a fundamentally different conclusion in the case of Ebola.
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only