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October 3, 1986

Cardiopulmonary Resuscitation

Author Affiliations

New Rochelle Hospital Medical Center New Rochelle, NY

JAMA. 1986;256(13):1723-1724. doi:10.1001/jama.1986.03380130050015

To the Editor.—  We were pleased to read the competent updating by JAMA of the "Standards and Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care (ECC)."1 We would like to point out an area in the section dealing with criteria for withholding CPR that may be open to misinterpretation and where clarification is needed: "Decapitation, rigor mortis, and evidence of tissue decompensation and extreme dependent lividity are usually reliable. When they are present, CPR need not be initiated."1(p2980)Although the author does, quite correctly, go on to state that "drugs or hypothermia" should be considered, we fear that a large number of observers may not be qualified to ascertain correctly the presence or absence of rigor mortis in certain situations. This is particularly so if a decision regarding CPR is to be made independently by the "average" adult member of the community, which is the ultimate goal