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Overview: Queensland Health Acute Resuscitation Plan (ARP)

The Acute Resuscitation Plan (ARP) was implemented in Queensland Health facilities in 2009 to replace Not for Resuscitation (NFR) Orders. The ARP is a medical order signed by the most senior doctor available and designed to provide clinical direction in the event of a patient’s acute deterioration.

The ARP records resuscitation planning outcomes following discussion with the patient, or their substitute decision-maker if the patient lacks capacity, and other members of the multidisciplinary team.

The ARP:

  • Is a statewide form completed by the most senior medical officer available.
  • Guides conversations between medical officers, adult patients in community care settings.
  • Provides clinical authority for attending teams to act on its directions in acute emergencies.
  • If appropriately completed, complies with guardianship laws which requires the pathway for decisions about life-sustaining measures to be thoroughly documented.
  • Records details about the patient’s:
    • diagnosis and likely prognosis
    • capacity to make healthcare decisions
    • proposed resuscitation management plan in the event of acute deterioration
    • substitute decision-maker(s)
    • preferences about life-sustaining measures, including whether they refuse or request cardiopulmonary resuscitation (CPR)
  • Offers a proactive approach to resuscitation planning, including what treatment will be provided.
  • Prompts a broader conversation about planning for end-of-life care, including whether CPR and other life-sustaining medical treatment should be attempted, and under what conditions.
  • Represents only one document in the suite of paperwork involved in advance care planning.
  • Ideally should be completed in the context of ongoing discussions with the patient or their decision-maker about optimum treatment and care now and into the future.
  • Was designed as a short form to be prominently located at the front of a patient’s medical record to be readily found in acute emergency situations.
  • Can establish if there are potential conflicts  to resolve with the patient and/or the substitute decision-maker(s), for example, where there are requests for non-standard forms of medical treatment or treatment that is not clinically indicated.
  • If appropriately completed, limits situations where urgent decisions are needed and there is limited information about the patient or understanding about what they would have wanted.
  • Is not a legal document like an advance health directive, and should not be relied upon as the consenting mechanism; consent from the substitute decision-maker(s) recorded on the ARP may also be required.
  • Ordering Acute Resuscitation Plan forms

    The Acute Resuscitation Plan and Paediatric Acute Resuscitation Plan forms can be ordered online via OfficeMax using the OM code. Alternatively FAMMIS Material Numbers have also been allocated for areas that are required to raise FAMMIS purchase orders.

Form IDForm TitleOM CodeMaterial FAMMIS NoPacking Unit
SW065Acute Resuscitation Plan431704110232142100
SW267Paediatric Acute Resus Plan4327411 100
Last updated: 30 August 2017