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During a patient cardiac arrest in a hospital or other medical facility, staff may be notified via a [[Hospital emergency codes#Code Blue|code blue alert]].{{sfn|Marks|2006}} A medical response team, based on the institution's practices and policies, attends to the [[emergency]].{{sfn|NBC News|2008}} The team will perform [[cardiopulmonary resuscitation]] in order to re-establish both cardiac and pulmonary function.{{sfn|Braddock|1998|loc=When should CPR be administered?}}
Cardiopulmonary resuscitation may be withheld in some circumstances. One is if the patient has a [[do not resuscitate]] ("no code") order,{{sfn|Braddock|1998|loc=When can CPR be withheld?}} such as in a [[Advance health care directive|living will]].{{sfn|Braddock|1998|loc=What if the patient is unable to say what his/her wishes are?}} Another is if the patient, family member, individual with [[power of attorney]] privileges over the patient, or other surrogate decision maker for the patient, makes such a request of the medical staff.{{sfn|College of Physicians and Surgeons of Ontario|2006}} Surrogate decision makers are considered in a hierarchy: legal guardians with health care authority, individual with power of attorney for health decisions, spouse, adult children, parents, and adult siblings.{{sfn|Braddock|1998|loc=What if the patient is unable to say what his/her wishes are?}}
A third situation is one in which the medical staff deems that CPR will be of no clinical benefit to the patient.{{sfn|College of Physicians and Surgeons of Ontario|2006}} This includes, among other cases: a patient in severe [[septic shock]] and/or [[multiple organ dysfunction syndrome]] whose organ damage cannot be contained and reversed any longer, one who has had an acute [[stroke]] that has irreversibly damaged vital brain functions needed for life beyond repair (i.e., in the brain stem), or who has advanced and incurable [[metastatic cancer]], and one with severe [[pneumonia]] which is no longer treatable with assisted ventilation methods and medication, which all have very little or no realistic probability of success.{{sfn|Braddock|1998|loc=When is CPR not of benefit?}} There is also a low probability of success for patients with severe [[hypotension]] that resulted from shock or severe illness or injury, and has not responded to treatment (and which was not induced), severe cases of acute or chronic [[renal failure]] or [[end stage renal disease]] (where dialysis and other renal replacement therapies either are no longer working or were not adequate, and where a transplant either can't be found or is not an option), end-stage [[HIV/AIDS|AIDS]] and its accompanying severe opportunistic illnesses (which are not responding to antiretroviral and drug therapy and/or the white blood cell count is too low), or those who are older than about 70 and/or homebound (where they and/or their guardians, instead of a DNR order, have authorized such half measures and the law permits it).{{sfn|Braddock|1998|loc=When is CPR not of benefit?}}
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