Does CPR really work?

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Thursday, July 11. 2013

Sometimes.

Emergency help on the street did work for Gerard, but the one time I did a sidewalk CPR the 45 year-old ended up with brain damage, but alive. Of course, the most difficult part for amateurs is to diagnose the need for it. People who turn pale and faint do not need CPR.

From the article:

Many veteran physicians have begun to opt out of the resuscitation practices they often administer to their patients. In a 2012 article published in The Guardian, "How Doctors Choose to Die," retired physician Dr. Ken Murray reveals that members of his profession frequently turn down everything from chemotherapy to CPR.

He notes that years of witnessing and administering "medical care that makes people suffer" leads many doctors diagnosed with terminal illnesses to choose to spend their last months or years at home and without medical treatment. Murray recalls some fellow physicians who go as far as getting tattoos that read "no code" to remind rescuers to forgo any attempts at revival.

Murray is still an advocate for learning CPR, but he warns against hoping for miracles.

Posted by Dr. Joy Bliss in Medical, Our Essays, Psychology, and Dr. Bliss at 20:00 | Comments (10) | Trackbacks (0)

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I remember asking about the survival rate back when I took CPR/First Aid 1000 years ago. The instructor told me there was maybe a one in four chance CPR would work, depending on the variables. IOW not good.

The instructor also told us that if we ever needed to use CPR, the odds were good that it would be used on a loved one.

I believe that for many of us, for our peace of mind if nothing else, it is important to try and do everything possible, even if it is against the odds, as opposed to just standing there picking our nose and waiting for the paramedics to arrive.

#1 feeblemind on 2013-07-11 20:39 (Reply)

I have seen a few good saves. I am 75 and want no special measures when I am going out. If I were 35, I might feel differently.

I've done CPR in a sailboat cockpit on a fellow who collapsed almost in front of us. My wife, an ICU nurse, and I did CPR on him only to learn that the paramedics immediately pronounced him after we left them to carry on. He was moving when we were doing CPR. The EMT folks may be less interested and may have something to do with poor outcomes.

I once salvaged a young woman who had arrested at home from heart block undiagnosed by her GP. She was very sick for a few days but recovered and worked as a volunteer at the hospital for the next 25 years. It's not always hopeless.

#2 MikeK (Link) on 2013-07-11 21:33 (Reply)

As a paramedic, 187 cardiac arrests in my career. 47 of them walked out of the hospital alive--breaking the stats, maybe being lucky or a crackerjack medic helps. Last year, 7 out of 11 of my cardiac arrest patients walked out of the hospital alive. Every one of them of my saves had CPR ongoing before I arrived. Read: None of the advanced drugs, skills and airways saved their lives, just CPR and someone using a defibrillator on them. (Advanced drugs and skills can get a heartbeat back in a hamburger--walking out of the hospital is the new endpoint.)

I am a CPR instructor and if I could afford it I would carry a defibrillator in my car.

Learn CPR. The life you save could be someone you love.

As an aside, I'm 0 for 7 this year. Oh, well.

#3 mfross on 2013-07-11 22:55 (Reply)

Well, all I can say is "Worked for me."

But it has to done with strength and vigor and, strangely enough, to the tempo of the BeeGees "Staying Alive."

I'm a fan. A big fan. But then I was lucky. Lucky that the Paramedics got here quickly and lucky in the fact that I was in Seattle when the survival rate is double the national average of around 7%.

#4 vanderleun on 2013-07-11 23:27 (Reply)

In May 2006 my heart stopped while I was doing post-Katrina recovery work at Keesler AFB. A couple of GIs tossed me in the back of a truck and took me to the general hospital in Biloxi. On the way they administered vigorous CPR to me. So "vigorous" that they broke my ribs and punctured my lungs, causing one of them to collapse. When they got me to the hospital I hadn't breathed for over 15 minutes. I had no brain activity, no pupilary response. I was dead. But the doctors there went to work on me anyway, and revived me.

If those GIs hadn't known what to do, hadn't so doggedly blown air into me and beaten my chest so hard that it broke my ribs and punctured my lungs, then the doctors probably couldn't have brought me back.

The next few weeks were like climbing out of a hole; my brain had shut down and the re-start was confusing. Seven years on I still occasionally stumble across empty spaces in my mind. Maybe that's what repentance is like -- empty spaces where something once was, but which you're better off without.

I might not have been missed much had that day in May turned out differently, but I like my life, and the seven years since receiving that "vigorous" CPR have been a gift to me. I, therefore, remain a staunch advocate of CPR.

#5 Tom Henderson on 2013-07-12 00:20 (Reply)

What those guys did was exactly what was supposed to happen. The dirty little secret of CPR is not to "compress" the chest, but "COMPRESS" the chest and if you break some ribs, so much the better - makes it easier to actually massage the heart externally and potentially keep someone alive.

I'm not quite as good as mfoss - as a volunteer medic in a rural setting you don't get a lot of chances to work miracles with CPR, but I do have one save (save meaning that they patient walks out of the hospital and continues with their lives) out of seven attempts at CPR.

If you look around, you can find a refurbished Physio-Control AED for around $500 - perfectly good units, they've just been refurbished and firmware updated. I've got one in my truck, one in the wife's car, one in my "GO" bag and at home.

Ain't takin' no chances - not this guy.

#5.1 Tom Francis on 2013-07-12 08:51 (Reply)

You got COMPRESS right. After I woke up thirteen days later I still was sore in the chest for most of a month if not longer.

Was I complaining? Not a bit.

#5.1.1 vanderleun on 2013-07-12 15:17 (Reply)

But...it works every time on TV! (TV lies to us.)

#6 Sam L. on 2013-07-12 10:41 (Reply)

Our rural volunteer fire department has an AED and CPR training. We've brought back one person that I know of: a man around 50 years of age who collapsed out of the blue in front of a friend, who started CPR. He recovered fully. Everyone else died--many dozens during my brief tenure--but our calls tend to be to people who probably were far beyond help long before we got there. We get a lot of calls first thing in the morning for people who died during the night. The shocked, grieving families don't know what else to do but call 911.

#7 Texan99 on 2013-07-12 11:10 (Reply)

I served as a volunteer rural EMT for several years. We had a few 'saves' but only one from CPR, and it was an otherwise healthy 45 year old male.

All the others [I don't remember any being younger than 65 or so, but none were really middle-aged or younger] died. And we sometimes had relatives insist we perform CPR on pretty obviously dead patients.

And, yes, if you do it right you're very likely to break ribs, especially on older folk. We were honest about that, and it probably meant we ended up with a few less volunteers than we would have.

#8 JorgXMcKie on 2013-07-12 12:49 (Reply)

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Thursday, July 11. 2013

Does CPR really work?