Patient comfort best practices

[Boho]

When you say "CPR isn't indicated when the patient is breathing" you cause inaction at times when CPR could save a life. Agonal breathing needs to be treated with CPR.

‘She’s sort of breathing’: What linguistic factors determine call-taker recognition of agonal breathing in emergency calls for cardiac arrest?
Resuscitation. 2018 Jan;122:92-98. doi: 10.1016/j.resuscitation.2017.11.058. Epub 2017 Nov 26. PMID: 29183831.

It is unreasonable to expect lay callers to know that agonal breathing is not effective breathing. However, a lay caller will typically realise that the patient’s breathing is not normal. It is thus logical that they would describe it as a type of breathing. Therefore, we should expect callers to describe agonal breathing as a confirmation ('yes but he’s gasping') rather than a disconfirmation ('no he’s gasping', invented example).

There is a lot of misleading information on this from all sources, for example, some sources say that agonal breathing is irregular. Agonal breathing does not always appear to be irregular. It could simply appear as labored breathing. I've seen it and subsequent CPR given by medical professionals, and I've researched it. What people on this forum of unspecified qualifications say doesn't effectively counter that.

Some more information related to patient comfort:

https://www.ems1.com/ems-products/c...eness-from-high-quality-cpr-SZmObIPSgekokpbf/

EMS leaders and clinicians warn that patients receiving high-quality CPR, especially from mechanical CPR devices, can achieve some level of consciousness or alertness without a spontaneous heartbeat.

The use of conscious sedation in elective external direct current cardioversion: a single centre experience

We learned that the use of conscious sedation in elective DC cardioversion is safe and tolerable. Even though it may seem cruel to use conscious sedation as the patient may awake or appear to be in pain when the shock is delivered, our study showed that 100% of our patients did not remember the procedure by 4 hours post-procedure

So four hours later and it's just something from the past that doesn't matter? Same as when a person suffers and then dies? Does that not matter after four hours?

 

[MichaelB]

Thanks for an interesting discussion.