The hope is that after activating EMS or calling in a code, that you can buy enough time until help arrives — an AED, a manual defibrillator, advanced life support, oxygenation, drugs, etc. The truth is that we all have an expiration date. Experienced paramedics who've treated dozens of cardiac arrest victims will tell you that some that should have survived, did not. And some that looked as if they had no chance of survival, did just that. All you can do is give each cardiac arrest patient the best chance of survival.
CPR was never meant to directly save lives. This may sound strange, but the reality is that CPR just keeps people dead longer. You must approach CPR with this understanding, along with an understanding of cardiovascular physiology.
The difference between what CPR really is versus our perceptions of it can be vast. The truth is this: no matter whether we perform high quality CPR, the person remains dead, regardless of who they are.
If you do everything correctly and the patient remains unresponsive, you didn't fail. The patient simply remained dead, for whatever reason. However, this unfavorable outcome doesn't negate one very important fact — by performing high quality CPR, you gave the patient the best possible chance of survival.
Because if you don't perform CPR, except for a bonafide miracle, that person will rapidly go from clinical death to biological death and remain that way.
That's why an important takeaway is this: people in cardiac arrest don't die. They simply remain dead. EMS professionals will tell you that the people they saved using CPR show amazing amounts of appreciation, as they get to spend another Christmas with their families. They get the pleasure of seeing another birthday come and go. So, yes, it is worth trying.
And in fact, the act of trying should be viewed as a success, as it's own reward, regardless of the outcome. Imagine if you were in cardiac arrest. There's nothing more beautiful than knowing that someone did everything possible to try and save your life. The effort and the act of helping is all that matters. At least, that's how it should be viewed. Something to remember — we don't know at what point victims of cardiac arrest can no longer sense or hear what's happening around them.
The research is unclear. However, some have come back from cardiac arrest and were able to recount certain aspects of their own life-saving protocol while unconscious. Even if that person remains dead, there is a chance that their last impression or experience in this physical world was that of love; that someone cared enough even strangers to put themselves in a position that might clearly be outside their comfort zone, and risk horrible failure, for that slight chance to help another human being live.
This is why CPR should never be measured in terms of failure and success. Because failure is not making an attempt to help in the first place. The success comes with the effort, and nothing more. More common are the "unhealthy dead": those with terminal illnesses, the chronically ill and patients who do not receive CPR within five to 10 minutes of cardiac arrest. Many survivors suffer abdominal distention or broken rib cages; some have severe brain damage from being without oxygen for so long.
Still, trauma workers, including physicians, nurses and EMTs, are required to do anything and everything in their power to revive the patient unless an advance directive -- a specific written and signed order -- specifies that resuscitation should not be performed. Many veteran physicians have begun to opt out of the resuscitation practices they often administer to their patients.
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. Not everyone agrees. Saying that CPR is ineffective is "the wrong attitude" and a "self-fulfilling prophecy," said Dr. Forget trying to blow in a person's mouth. I think people think about that; it just grosses them out.
Just do chest compressions. And when you do them think of the song "Staying Alive. You're doing deep chest compressions, beats a minute and just keep pushing on that person's chest until the ambulance gets there. Interviewer: And just for a refresher course, you put your hands right on their heart? Is that where you're pressing? Madsen: So, you're going to put it right over their sternum. So, if you feel on their chest, the hard bone. Madsen: So, you're going to get right over the center of the chest, right over that really hard bone about halfway up and then get right over them with your fists down on the chest with your arms straight out and locked.
Get your full force over them. We say to our medical students when you're doing CPR if you're cracking the person's ribs, you're doing the right thing. Madsen: Because you have to get that much force. You have to get down and really push on the heart. If you're breaking ribs, it's fine. Again the person's chances of living are 1in We can easily treat broken ribs. You're saving their life potentially. Madsen: Another thing to keep in mind is you can get really tired doing CPR, you know.
People tire out in maybe two minutes with those chest compressions, so if there are other people there, rotate out. Have people swap in. Keep the chest compressions going. Accessed October 22, American Heart Association News. Who gets CPR from bystanders? Heart disease and stroke statistics— update: a report from the American Heart Association external icon. Emergency Treatment of Cardiac Arrest external icon.
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