I’ve learned something unpleasant about CPR today

Trained as an EMT to be able to handle any injuries underground, our instructors always warned us of the causations that may occur if we did CPR. When 85yo DM was in hospital, her doctors reminded us, my younger siblings were shocked at what may happen.
 
Maybe things have changed in the last few decades, but the article didn't say anything about EMTs and/or nurses having to perform CPR unless 1) a DNR is present, or 2) the patient is obviously deceased (decapitation, etc). Those were the rules I learned decades ago when I was an EMT, do CPR until presented with a DNR or a doctor declares the patient dead. I'd be glad if liability law has changed, but they don't address that at all. The author seems to have only talked to physicians, so they're probably only thinking of hospitals, nursing homes, and other fully staffed medical facilities, where the decision is easier (and the staff can encourage any family to document their end-of-life choices).
 
My Mom always joked about having DNR tattooed on her chest, something to be said about that.

It is important to tell everyone--family, drs, etc what your wishes are.
Complete your Advanced Directives, give copies to your Doc, your family.
If you are of advanced age, seriously ill, or medically frail, consider working with your Dr to also complete a POLST form.(Physician Orders for Life Sustaining Treatment) This is usually bright pink and clipped to your refrigerator and rescue folks should look for it or ask about it.

Most medical and emergency personnel are required to begin CPR, and other life sustaining actions unless notified of Advance directive or POLST.
 
pacergal said:
My Mom always joked about having DNR tattooed on her chest, something to be said about that.

It is important to tell everyone--family, drs, etc what your wishes are.
Complete your Advanced Directives, give copies to your Doc, your family.
If you are of advanced age, seriously ill, or medically frail, consider working with your Dr to also complete a POLST form.(Physician Orders for Life Sustaining Treatment) This is usually bright pink and clipped to your refrigerator and rescue folks should look for it or ask about it.

Most medical and emergency personnel are required to begin CPR, and other life sustaining actions unless notified of Advance directive or POLST.
Click to expand...

In Texas, we have a special form for the POLST which covers instructions for EMT's, Emergency Rooms (not always a part of the hospital even if in the same facility), Dr's offices, skilled care facilities, etc. A standard DNR won't work in those places here (ask me how I know!).
 
pacergal said:
Most medical and emergency personnel are required to begin CPR, and other life sustaining actions unless notified of Advance directive or POLST.
Click to expand...
Thank you, that's what was bothering me about the article; it made it sound like medical providers can and should just use their judgement and decide not to do CPR on patients who are in arrest!
 
aja8888 said:
In Texas, we have a special form for the POLST which covers instructions for EMT's, Emergency Rooms (not always a part of the hospital even if in the same facility), Dr's offices, skilled care facilities, etc. A standard DNR won't work in those places here (ask me how I know!).
Click to expand...

A very good point. When my mom got into her 90s, she made a point of filing a DNR order at the local hospital. At 96 she was found unconscious one evening at the memory care facility and of course they immediately called the squad to transport her to the ER.

They notified me, and I rushed over there and talked to the MD on duty. Much to my surprise, he said "I know she has a DNR, so all I'll do is make sure she's comfortable." Huge relief, and she passed on quietly the next day.

So a DNR can sometimes be valuable, although as you said it's not always honored. I found that out much earlier with my dad. He was more than ready to go, but a hospital doc simply decided to ignore his DNR and he wound up with several months of very uncomfortable life with a feeding tube before he finally went.
 
The young wife was a volunteer EMT for 25 years. Most of the time, they were unable to revive people using CPR. And when they did, the people often died almost immediately in the hospital anyway.
 
All end of life decisions are personal choice.

tenant13 said:
https://www.npr.org/sections/health...-may-be-preferable-for-many-than-enduring-cpr

I already knew that I didn’t want to prolong my life at all costs but this is something I wasn’t aware of. Something to think about.
Click to expand...

So on 7/13/2016, I was 68 and I had an out-of-hospital cardiac arrest. I was lucky, very lucky that I was at my cardiologist when I arrested. I had 3 cardiologists, 1 PA, several APRNs, several RNs, a bunch of curious MAs and 1 very concerned wife resuscitate me successfully. No brain damage occurred and I am alive almost 7 years later.
My ribs were bruised and hurt for about 4 days from the CPR. The defib machine pads left burns on my chest that took about 10 days to heal. The burns itched a lot during healing but I did not notice the itching much since I received a balloon valvuloplasty, a TAVR, and an AICD/pacemaker to fix the cause of cardiac arrest.
I had a DNR then and still have a DNR now. My cardiologists did not know I had a DNR. After almost 7 years, I am very happy they resuscitated me, regardless of the DNR.
I still believe in DNRs but they are not perfect. Your personal choice.
 
And then there was the game warden who spent his career at the state Department of Natural Resources and was so proud of what he did that he had the initials tattooed on his chest. :facepalm:
 
Thanks for the info. When DH was in hospice care at home in his last months, we had a priest who was a former EMT and a family friend administer last rites. I asked the priest what to do when DH's time came. He said NOT to call 911- they'd start CPR. DH was dying of acute myeloid leukemia so CPR would have been of little use. Instead, I followed his instructions and called the hospice nurses.
 
The circumstances matter.

There is a difference between a seven-year-old going into the hospital for a tonsillectomy and an octogenarian with a terminal diagnosis.

Once in a while you hear about some kid being pulled out of a lake/pool . . .

And yes, if you have a terminal family member at home who is ready to pass - contact hospice, do not call 911.
 
tenant13 said:
https://www.npr.org/sections/health...-may-be-preferable-for-many-than-enduring-cpr

I already knew that I didn’t want to prolong my life at all costs but this is something I wasn’t aware of. Something to think about.
Click to expand...

The majority of states have some version of POLST. Michigan also happens to have a DNR form you can fill out and it doesn't expire. Tattoos are a poor substitute. :)Many Hospitals will put a copy of a advanced directive in your chart. IMO, the system is too biased toward aggressive treatment even for the elderly and infirm where interventions are not very helpful.
 
My parents both had DNR documents in addition to trusts and wills. My brother who was designated as the main contact person was on a vacation while our 89 year old Dad had been in his decline and bed ridden in a hospital nursing facility. No one knew where my brother was or could locate him so I was contacted by the hospital when Dad started to seriously fail, was unconscious, and placed on life support systems. It was near the end and I had to bring in the paper work to show I had to make the decision. It was the worst thing I ever had to do but it was time, it was Dad's wish. He was tired of the fight, failing health, and only kept alive with machines. The Drs and I were in agreement and I cried for days. I hope when it is my time someone will be there to insure my DNR wishes are followed.

Cheers!
 
CPR is just like any other medical intervention. There needs to be a risk/benefit calculation. Unfortunately, the ethics involved (professional AND personal) can get in the way.

One anecdote which I know of personally: Good friends of mine (a married couple) run a small bush-hospital in Africa. I went to school with him in the early 80's. He's a doctor and she is a nurse/administrator. On a plane flight, she developed a clot which stopped her heart. He kept her alive for 2 hours with CPR. I don't know how he had the stamina - but I guess when it's your wife, you go all out. She was 60 years old. She is now over 70 and in good health for her age. When they travel every few years, seeking funds from the West to keep the hospital going, DW and I always provide her an upgraded air ticket (pod class - for want of a better word) so that she runs less chance of developing a clot.

To me, the issue is to make a careful judgment about whether to resuscitate or not. We must take the "morality" out of it and make a sound judgement on the needs/wants of the patient. All life is "sacred" but that doesn't mean all life must be maintained at all costs. YMMV
 
Daughter is a hardworking cardiac ICU nurse, has done CPR in hospital setting and has described how intense the CPR effort is. I hope I never need it …. Yikes!!!

What she described is way more intense than what i learned as a Boy Scout in Red Cross CPR class so many years ago.
 
I'm personally 0 for 2, the second one being my father who had a bad heart and a final MI at a grocery store. I had some help there but that ship had sailed.
I lost a brother in a cold water drowning that they did not even try to resuscitate.
Even in 1975 those guys should have known that he had a chance.
 
Koolau said:
To me, the issue is to make a careful judgment about whether to resuscitate or not. We must take the "morality" out of it and make a sound judgement on the needs/wants of the patient. All life is "sacred" but that doesn't mean all life must be maintained at all costs. YMMV
Click to expand...

It's nice when that can happen. When somebody has a cardiac arrest at the mall there is typically no information for the first res ponders. It is tragic to do futile resuscitation measures on somebody in the hospital who didn't want it and had the opportunity to opt out.
 
Very interesting info. I was surprised "Quote >> Bystander-initiated CPR may increase those odds to 10%".

Unless I read it wrong, I would have thought giving CPR would have had a better outcome.
 
Having been an EMT I'd probably only do CPR if I saw someone collapse right in front of me.

After screaming "call 911!" and "go get an AED!" to any bystanders.

If I came upon someone who was "cold" (room temperature) to the touch I wouldn't bother.
 
Years ago when I was trained, we had an EMT talk to us. The EMT told us he had NEVER brought anyone back. Of course, he always showed up after being called so there was a time lag.
 
Koolau said:
Years ago when I was trained, we had an EMT talk to us. The EMT told us he had NEVER brought anyone back. Of course, he always showed up after being called so there was a time lag.
Click to expand...

He may not have been a very good EMT :)
 
RetMD21 said:
He may not have been a very good EMT :)
Click to expand...

My gut says that your chances of saving someone you didn't actually see collapse are exceedingly small. Someone earlier in the thread pointed that out.
 
Originally Posted by Koolau
Years ago when I was trained, we had an EMT talk to us. The EMT told us he had NEVER brought anyone back. Of course, he always showed up after being called so there was a time lag.
Click to expand...


RetMD21 said:
He may not have been a very good EMT :)
Click to expand...

Not to pile on the levity but way back when, when I had to be qualified in this the instructor would always start off by regaling us with tales of all the times he had been at a restaurant, a movie theater, the park, the zoo, you name it and somebody "collapsed" and he got to save a life with his CPR skills. I remember thinking and laughing to myself "this guy is a regular angle of death. Everywhere he goes people collapse." I had never been anywhere where CPR would have been useful. I guess if your only tool is a hammer.....??
 
You must log in or register to reply here.

Similar threads

R
CPR
Replies
20
Views
1K
rk911
rk911
M
Karma? A Chilling Story
Replies
19
Views
2K
marko
M
T
Family of 4 moving into Tiny House on wheels
2 3
Replies
57
Views
5K
old medic
O
Lagniappe
Three Years In
Replies
12
Views
3K
flyingaway
F
Major Tom
Right Knee Replacement on 5/24
2
Replies
29
Views
3K
Major Tom
Major Tom

Latest posts

Back
Top Bottom