Table 1 Clinical vignettes

Vignette 1 : You work in MICU. Your beeper goes off for a CA in a young patient accompanied by a witness. You know that he’s 40 years old, has no previous medical history, is not taking any medication and was running with friends. You arrive at the scene first with your MICU team within 5 min. You quickly confirm CA. No chest compressions were started by the victim’s friends. They immediately give you a copy of the patient’s AD, found in his trail bag, which includes a DNACPR order.

Vignette 2 : You work in the Emergency Department. A healthy and athletic 40-year-old man with no previous medical history or treatment is referred by his family physician for obstructive pyelonephritis complicated by hyperkalemia. You have the physician’s referral letter and a copy of the patient’s AD, attached by his physician, which includes a DNACPR order. When you enter the room alerted by the alarms, the patient is unconscious, he is not breathing and the monitor displays a Ventricular Fibrillation Rhythm.

Vignette 3 : You work in a Medical Dispatch Centre. Your dispatcher assistant transfers the call: "Male / 40 years old / CA? / MICU sent / wife is calling". You take the call. The wife confirms that he’s unconscious and not breathing. You begin to give instructions to the caller on how to start chest compressions. On this occasion the wife asks you whether or not she should start chest compressions, her husband has written a DNACPR. On further questioning, you learn that the patient has no chronic pathology, is valid and athletic.