While most nursing homes have policies to administer CPR, a survey of aged-care facility managers found fewer than one in five thought heart attack patients should be revived if their hearts stopped.

The results of the study carried out late last year and earlier this year have prompted calls for new guidelines on when CPR should be performed.

Dr Bill Silvester, who heads the Respecting Patient Choices Program at Austin Hospital, said in his analysis of the findings there should be guidance provided on when and how to discuss performing CPR with residents and families.

''NSW Health state that it is reasonable to withhold CPR without explicit discussion with the patient or family if a) the resident or family do not wish to discuss it, b) the resident is aware that they are dying and has expressed a desire for comfort care, or c) the facility does not provide CPR as a matter of course, consistent with the values and practices relevant to their population,'' he said.

Of more than 400 aged-care facility managers surveyed, less than 20 per cent thought CPR should be initiated in cases of ''witnessed cardiac arrest'', despite four out of five homes surveyed having a policy of providing CPR if the need arose.

''This revealed a significant difference between what the staff thought would be appropriate for their residents and what they were expected to do,'' Dr Silvester wrote.

He said the use of CPR appeared to be driven by an expectation of what staff needed to do, rather than the effectiveness of the intervention.

''The reason we did this study was we were appalled at the number of elderly people being resuscitated in aged-care homes, and … ending up in the intensive care unit,'' he said. ''So we asked the ambulance people why this was, and they said they had no choice. The nursing homes … said it was because of expectation.''

smh.com.au