CPR

[RetMD21]

The other thread is too old for replies but there is a follow up NPR article complete with a photo of a no cpr tattoo. https://www.npr.org/sections/health...80009/cpr-aed-defibrillator-advance-directive

I think the main point is that CPR isn't magic, doesn't work all the time but can be very worthwhile in the right circumstances

old thread: https://www.early-retirement.org/fo...ething-unpleasant-about-cpr-today-118080.html

 

[rk911]

The other thread is too old for replies but there is a follow up NPR article complete with a photo of a no cpr tattoo. https://www.npr.org/sections/health...80009/cpr-aed-defibrillator-advance-directive

I think the main point is that CPR isn't magic, doesn't work all the time but can be very worthwhile in the right circumstances

old thread: https://www.early-retirement.org/fo...ething-unpleasant-about-cpr-today-118080.html

according to a paramedic friend when CPR does work it ain't like in the movies or on TV.

 

[Koolau]

according to a paramedic friend when CPR does work it ain't like in the movies or on TV.

The guy who trained me said he'd never had it w*rk - not once. He never saved a single person. But, he would keep trying and recommended that we try as well. So far, I've never needed my training - which is years out of date. YMMV

 

[RetMD21]

Making an effort is the default and maybe it shouldn't be for some but there are some inapiring stories. From the article

Nick Sakes, an avid cyclist from Minneapolis, was 58 when he collapsed on a ride at a busy intersection. A nurse in a nearby car saw him go down. He didn't have a pulse, and she performed CPR until paramedics arrived. Using a defibrillator, they found that he was in an abnormal heart rhythm called ventricular fibrillation, a common cause of cardiac arrest that is often responsive to electric shocks.

It pays to be healthy, not too old, and to get immediate action

 

[The Cosmic Avenger]

We got one person to the hospital with a pulse, and IIRC that was the only time we had to do CPR. Unfortunately, she was close to 100 and had a lot of health issues. The nursing home staff told us to stop CPR and said she had a DNR, but usually there's a "DNR" sticker on the chart or bed, so we asked them to bring us the order, and they made all kinds of excuses. Turns out that she didn't have one, but they tried to trick us into being liable rather than them, I guess, or could say she just passed away quietly without anyone noticing? I hope they got in trouble with the family for that.

 

[pacergal]

In almost 40 years of nursing, only had to initiate/participate in CPR twice.
Neither patient made it.

It is important to have Advanced Directive on file with your PCP, local hospital, and review with family.

 

[Koolau]

Making an effort is the default and maybe it shouldn't be for some but there are some inapiring stories. From the article


It pays to be healthy, not too old, and to get immediate action

Not to mention, being at the right intersection when you're heart vapor locks on you. It's really a crap shoot when it comes to CPR. Is there someone properly trained who is willing to give it a shot.

I've mentioned here before that I have friends (about 50 at time of this story) He is a medical doctor. She got a blood clot to the heart on a long flight. She essentially "died" and he brought her back and kept her alive for (IIRC) almost 2 hours with CPR. She is still living in her early 70s. She now flies only business class (while he flies cattle car.)

 

[RE2Boys]

I've initiated CPR about half a dozen times, never saved anyone. Most of the time I knew it was a long shot, but gave it my best shot, especially if responding to a home situation with family present. 40 years ago I was active in EMS (EMT and working toward Paramedic status). One time I was out for an early morning training run and came upon a person lying in the street. Good color, eyes constricted, whatever happened was only a minute or two ago. Started CPR and sent my buddy to pound on doors. Ambulance arrived, they quickly cut off his shirt and there was a long scar indicating major chest surgery. He had known problems and did not survive.

 

[SecondCor521]

I've only heard of one successful case, and it was one that involved a lot of luck. My dental hygienist's Mom was driving on the freeway, had some heart problem and wrecked. The person right behind them stopped, and he happened to be a nurse (ER nurse maybe) and started CPR within a minute or two. Cell phone called ambulance, maybe life flight, yada yada Mom is alive and fine.

I'm Red Cross CPR trained way back in the 80s so if I ever had to I'd do it the older style way, but that's still probably better than nothing.

 

[Aerides]

Damar Hamlin is a good case, but in a super-healthy person with immediate attention.

 

[braumeister]

It is important to have Advanced Directive on file with your PCP, local hospital, and review with family.

Very good advice. When my mom was close to the end, she was more than ready to go, actually looking forward to it as her quality of life diminished.

The final time, I got a phone call from her memory care facility that she had been taken to the ER as "unresponsive". I rushed over there and the ER doc immediately put me at ease, saying that he knew she had a DNR on file so he would do nothing more than make sure she was comfortable. She died the next day, so it went as well as it possibly could have.

OTOH, when my father was nearing the end, the doctors at his hospital refused to honor his advance directive, saying it would violate their Hippocratic Oath and they would make the decisions, not him. That resulted in him living an extra three months in a miserable condition and hating it.

So I'm a big believer in having your paperwork up to date.

 

[CaptTom]

...OTOH, when my father was nearing the end, the doctors at his hospital refused to honor his advance directive, saying it would violate their Hippocratic Oath and they would make the decisions, not him. That resulted in him living an extra three months in a miserable condition and hating it...

That's appaling!

Don't people sue for "pain and suffering?" It seems to me those doctors would be perfect candidates for that. Or at least find a way to make sure their bills for all those months of treatment don't get paid.

 

[SecondCor521]

That's appaling!

Don't people sue for "pain and suffering?" It seems to me those doctors would be perfect candidates for that. Or at least find a way to make sure their bills for all those months of treatment don't get paid.

Most of the time, families of the person want everything possible to be done. Doctors risk lawsuits for not doing enough far more frequently than they do for doing too much.

Best practice is what the earlier poster said - make sure you have your DNR (or POST or medical POA or whatever) on file with your doctor, your hospital, your insurance, your retirement home, and that everyone is on the same page regarding your wishes.

 

[harllee]

My DH saved someone about 5 years ago using CPR. It was a friend in her 60s who collapsed on the dance floor. She was barely breathing and was turning a bluish color. There was no defribillator available. He and another person took turns doing CPR until the ambulance arrived. The ambulance people told us she would probably not survive. She was put in a medical induced coma for a few days and then later had heart bypass surgery. She has told my husband numerous times that her doctor said his CPR saved her life. She is now back dancing.

My husband had the CPR training when he got his Auxillary Coast Guard Captains license--just a couple of month before the incident.

 

[braumeister]

Most of the time, families of the person want everything possible to be done. Doctors risk lawsuits for not doing enough far more frequently than they do for doing too much.

IMHO, that's irrelevant. What's important is what the person wants, not the family. That's why people go to the trouble of filling out those forms saying how they want to be treated at the end.

 

[SecondCor521]

IMHO, that's irrelevant. What's important is what the person wants, not the family. That's why people go to the trouble of filling out those forms saying how they want to be treated at the end.

I agree with you.

My comment you quoted was mostly referring to the less ideal but I think more common situations where the person didn't fill out the forms, or they can't be found, or the family disagrees with the person's wishes.

All I was saying is that if there's any doubt - there shouldn't be, but there often is - the doctors' and nursing homes' smartest and safest move to avoid a malpractice lawsuit is to overtreat rather than undertreat, so that's what they'll do.

 

[rk911]

The guy who trained me said he'd never had it w*rk - not once. He never saved a single person. But, he would keep trying and recommended that we try as well. So far, I've never needed my training - which is years out of date. YMMV

My training is way out of date as well. Over the years we did rescue breathing with no shield, then rescue breathing with a shield and now, I'm told, CPR is taught with no rescue breathing, just compressions.

I'm amused at when TV portrays docs at the ER doing CPR for maybe 30-45 seconds and then giving up. Prior to retirement I asked for 3 or 4 AEDs to be located at various points in our HQ building...the maintenance area, Ops Center, Admin offices, etc. Only one was approved. It's been 19-years since then and ops have moved to a new, much larger HQ. I hope they've placed additional AEDs in that building.

 

[braumeister]

I agree with you.

My comment you quoted was mostly referring to the less ideal but I think more common situations where the person didn't fill out the forms, or they can't be found, or the family disagrees with the person's wishes.

All I was saying is that if there's any doubt - there shouldn't be, but there often is - the doctors' and nursing homes' smartest and safest move to avoid a malpractice lawsuit is to overtreat rather than undertreat, so that's what they'll do.

I understand, and I knew that's what you meant. But my point is that when there is clear-cut documentation available, ignoring it is simply wrong. That episode with my dad was over 25 years ago, so it's just water under the bridge. My mom's experience was only about 15 years ago and left me feeling much better.

 

[braumeister]

Prior to retirement I asked for 3 or 4 AEDs to be located at various points in our HQ building...the maintenance area, Ops Center, Admin offices, etc. Only one was approved.

I have been surprised in Europe at how ubiquitous they seem to be. I love the Norwegian word for them -- looks like "heart starter".

 

[SecondCor521]

I understand, and I knew that's what you meant. But my point is that when there is clear-cut documentation available, ignoring it is simply wrong. That episode with my dad was over 25 years ago, so it's just water under the bridge. My mom's experience was only about 15 years ago and left me feeling much better.

I went back and re-read. I agree with you about your Dad's scenario. Not right what happened there. Hopefully a rare case and hopefully also getting rarer with time.

 

[rk911]

I have been surprised in Europe at how ubiquitous they seem to be. I love the Norwegian word for them -- looks like "heart starter".

I wonder what the stats are for AED 'saves'?