CPR saves lives. That’s the good news. The bad news is that the percentage of lives saved is much smaller than most people think, and there are times when real thought should be given as to whether to apply CPR or not. Scott brings the story, along with a heart-rending personal experience of CPR being applied to a loved one which, tragically, SUCCEEDED.
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18 replies on “CPR: Yes or No?”
Another factor to consider is being sued by a CPR survivor. Many people are victims of the misdeeds of even more others.
A society that finds beauty in letting people die has lost its way.
My brother-in-law dropped dead from a thing called “Sudden Cardiac Death Syndrome”. If you don’t know what that is, look it up. It’s a cardiac arrest but it’s rare. Surviving it is even rarer. Surviving Sudden Cardiac Death Syndrome to go on to live a reasonable quality of life is even rarer still.
It’s not the same thing as the much more common “heart attack” which is myocardial infarction.
He dropped dead right in front of my sister. Who had the presence of mind to call 911 and get help on the way, then call my Mom who lived a mile away and tell her to come immediately. While she was on the phone in both cases she was also administering CPR to my brother-in-law.
The paramedics arrived in only a few minutes, there’s a fire station just a few blocks away from where they lived at that time. They didn’t want to try to save my brother-in-law. She told them they had to try, his six year old son was watching out of a nearby window.
So they did. He ‘coded’ three more times enroute to the hospital which is only a few blocks away. They got him to the hospital and he survived even though he coded three more times in the emergency room. He would not have survived had my sister not done what she did.
I was overseas at the time and my sister called to ask me to come home. My brother-in-law was not expected to live and she wanted me to help raise her son. I was in the process of arranging my return to the U.S. when she called to let me know it didn’t look like coming home would be necessary and to cease efforts in that direction.
He had brain damage. He was still functional and over time his brain has “remapped” around the damaged areas and he lives a fairly normal life though he has some pretty aggravating memory problems. There were other issues to overcome too. Among other things he had a definite change of personality for the worse which has slowly improved over time.
That incident occurred 17 years ago. My brother-in-law has lived another 17 years and he is still alive because my sister refused to let the situation get the best of her.
In our security camera system I just saw him leave the house to walk his dog. His quality of life might not be as good as it would have been otherwise but it’s still a life he is glad to be living. He got to see his boy grow up, go off to college and land his first job. His son got to spend those years with his dad and those years are priceless.
If you asked him, he would tell you that he’d rather live than not and he’s grateful for his second chance.
Obviously there are circumstances that heroic efforts should be withheld. The situation dictates the response. What concerns me greatly is that people will see this video, or some such other information, and not even try when they absolutely should.
I just called my sister to make sure that I got the details and dates correct, after all I was overseas at the time. She told me that had she known the statistics were only a 7% chance of success she might not have tried. She’s glad she didn’t know that at the time.
Unlike me, she had never had any formal CPR training. She didn’t know about things like the precordial thump and she made several errors rendering CPR to my brother-in-law. All she knew about CPR was what she had seen on TV. That was enough. He survived anyway and he would not have survived had she made no effort at all. That’s not my opinion, it’s the opinion of the cardiologist that treated my brother-in-law.
You guys are in a ‘position of authority’ to most of the membership that will see this video and then there’s the larger audience on YouTube and Rumble. Be careful what you say. People have a nasty tendency to hear only what they want to hear and retain things that they should not while ignoring the things they should pay attention to.
I fly helicopters for a Life Flight organization (nearly 10 years now) and have seen and heard all sorts of stories. I have sat in my helicopter, engine running and the air conditioning working overtime, and watched my crew, along with a rotation of firefighters, do CPR on an accident victim laying on a hot gravel road. 45 minutes they worked on her, to no avail. They say the outcomes for a traumatic injury and CPR are very different than from a cardiac arrest. Of course that also depends on age. An Uncle of mine was next to my Aunt (73 years old) when she collapsed and then traded off with my Cousin on CPR for 45 minutes. The EMT’s finally arrived, gave a shock or two, and got her back. She’s now lived another 5 years with no deficits at all. We all know just how fortunate she is, and an amazing statistic.
Now, just two weeks ago I flew to pick up a man that had been out dancing with his wife and celebrating his 85th birthday. He’d had a couple of drinks so she drove, and he just clicked off. 45 minutes of CPR and shocks in the hospital, that was just a 2 minute drive away, and nothing. He was gone, and to her credit she let them call it. That’s how I’d like to go.
We have all seen traumatized family members tear up a DNR and insist that everything be done to save their loved ones. Just because you have a piece of paper or instructions doesn’t mean that you will get your wishes. I have flown a lot of very old and frail people to a hospital, fully knowing that they likely are destined to a long, difficult decline as described in the podcast. That is tough on us.
Bottom line is that it is a very complicated issue. There are certainly many stories of good saves, many stories of terrible outcomes, and many stories of people just doing what people do; dying. Immediately. My own preference: I like the idea of immediately.
My son does what you do, he’s the national relief standby for his company. They fly him to whatever coverage area needs him so that the pilots in that area can get their days off, vacation, etc.
He’s been doing that job for just under a year since he retired from the Navy. I can’t recall the details or name of the company he flies for.
He’ll call me on Father’s Day, I’ll try to remember to ask him if he knows anyone named Mark Sales.
You will never convince me to just let somebody die who has a chance. The statistics on the success of CPR are thrown off because of multiple reasons. There are those who should have been made “No Code” by their family or themselves. Lots of people whose health situation is hopeless are panicked by the thought of dying and won’t agree to sign papers to allow them to die, wanting heroic measures. Another issue is trauma staff doing everything they can on patients who arrive in seemingly hopeless conditions – because they have been successful in the past on similar cases.
I am asked to see emergency rescue efforts usually because of airway obstruction, which, if fixed, can resuscitate someone rather quickly. I was successful most of the time with this particular situation, namely relieving airway obstruction. The time I wasn’t, I got sued for being too late to save the child despite having all the proper equipment and staff. With 2 year-olds, there is no room for lack of oxygen to the brain. I got the airway maybe a couple of minutes too late. This is not an easy job, and I didn’t sleep for a year after that case, even with everyone telling me I performed well given the circumstances.
And it is offensive to think that it ever occurred to me that I would care about making money doing this emergency work, as has been posited in these comments sections. I doubt that I even billed half the time I was called.
Bottom line is not all CPR attempts are the same, doing CPR on dead people doesn’t work, EMTs are instructed to attempt on questionable cases, more people need to learn to accept their mortality and sign the “no heroic measures” papers, and I’ve witnessed “saves” many times. Sure, pumping compressions and breaking ribs on a brittle-boned octogenarian with end-stage cancer whose heart stops happens when it shouldn’t. But it is not our call when they refuse to allow themselves to die.
thanks for chiming in Dr. Jackson. I will note that over the 2 decades that i have been getting CPR and first aid training certs (every 2 years in VA) that the training has changed. During our last class the instructor pointed out emphatically on older victims to check for a bracelet or ask the loved one if there was a DNR. He also said that the loved one would probably lie.
I also wish the medical dramas would at least do a better job in the aftermath of a successful recovery from compressions. You see these people smiling in a hospital bed rather than in pain.
Personally, I have already pre-decided that my 93 yr old FIL and 89 yr old MIL are adamant and correct in their assessment that they don’t want CPR if they go down. So I would not treat them, I suspect that would be hard to live with. But no harder than watching my own mother in her bed take her last breath after reminding me the day before of the DNR etc taped to the fridge.
Death is always hard to bear. Being prepared helps. Having worked out in your own mind what you’ll do is a sort of training that kicks in when the crisis comes.
This applies to a lot more than your situation. People need to think about and face the kind of hard “what if” or “if when” realities they may encounter. Mental preparedness is cheap, takes little of your time and is more a matter of personal internal honesty than it is a matter of resources and time.
I assume being as you’re talking about your inlaws that you’ve discussed this in detail with Mrs. Ron? She’s the one you’ll have to live with whichever way you decide to proceed. Being as they’re her parents, if she’s onboard with your positions then there shouldn’t be any deserving recriminations later.
I have indeed discussed it with the Mrs. However, I do believe that when the time arises, if she and I are present she definitely falls into the category of changing her mind and wanting whatever can be done to be done in the moment.
Fortunately, shortly after my mom passed, and in the midst of the Covid kerfuffle, they sat all three of their kids and both Sons-in-Laws down and told us that what’s and wherefore’s of their end of life desires.
I think that will, at the very least, slow down the response if anyone is there.
Frankly they are both of an age that I expect what we will get one morning is a phone call that one of them passed in the night.
Depending on which one is when the really tough part would come. Those decisions I cannot get any of them to actually discuss ahead of time. It is just not a subject upon which they will broach interest.
My Sister-in-Law is generally the take charge type; however, I think she talks a good game and will actually not be able to look ahead when the time comes.
Surprisingly, though my wife thinks she’ll be the one to freeze, I actually think she will get through the first wave of emotion pretty quickly. Mrs. Ron is much tougher than she gives herself credit for being. Her still being on planet earth rather than within it is testament to that.
Yeah, if you read my story about my brother-in-law you’ll see that my sister took the best, and most difficult course of action and saved him. He was 17 years younger then but …
My sister has never been the heroic type. She’s more apt to lock up than anything, at least in my prior experience with her. Now it just might be that was because I was there and I don’t hesitate even a second to go on the “attack”. Whether the problem is a bad guy with a gun or a neighborhood kid hit by a car, I move into action very quickly and so she never had to. Her big brother was there to do that stuff for her.
When I was gone and her husband dropped dead, she went into action immediately and did exactly the right things. That bumped my respect for my sister up several notches.
Mrs. Ron is likely similar in this regard. I found out a long time ago that you really never know what you’ll do until you have to do it. It is my experience that people will do the right thing when they must. Especially people of high character. It’s been my observation that character is the primary deciding factor.
So in that regard and though I don’t know her personally I’d say that Mrs. Ron will do what needs done when it needs to be done.
All of that said, I applaud you for thinking about these things ahead of time. Ignoring a hard subject is the best way to be defeated by circumstances.
What if the only real beneficiary of CPR is the health care industry? SOMEBODY got paid for the 6 months of care your octogenarian congregant received. Made me think: what if that is the ONLY reason CPR is so widely taught: to exploit the labor of the masses to benefit the coffers of a few.
Damn Covid response has irreparably damaged my thinking about public health messaging.
{Shrug} I know at least one ‘real beneficiary’ who is walking around today after having his life saved by CPR 17 years ago. If that was you or someone you cared a lot about, which way would you want someone to jump? To try to save you, or yours, or not? What if they didn’t because they had heard this CPR stuff is all a scam to generate cash for medical facilities?
Responses like yours are what worries me about this sort of video. I’m not criticizing you personally. It’s a matter more of human nature than anything else. People draw the wrong conclusions, get the wrong message, hear the parts that they can relate to or that feed their confirmation bias, etc.
I’d really hate for someone to die when they didn’t have to. I’m not particularly convinced that Scott’s conclusions, well meaning as he is, are right. I think that all else being equal, erring on the side of saving a life is the correct response to this type of situation. If someone else then makes money from that, oh well.
My takeaway from this discussion has made me realize that CPR is not necessarily done to save one from dying, rather to save oneself from the loss of someone dying… Akin to the thought of “What more could I have done to save them? Somewhat a selfish mechanism to escape the pain of that loss… At the end of my mothers’ life, the hospital was busy trying to keep her alive and it came to a point where I said, “She’s ready to go, let her go home…” “home” was a euphemism that said everything by saying little and honoring my mom with her wish to reunite with those who’ve passed before her… She was 74…
I am conflicted on this. In the 80s, I was a firefighter in Arizona for about 4 years. I was an EMT, and then an IEMT (which is between EMT and Paramedic). And I was a CPR instructor. I performed CPR many times, sometimes more than once in a shift. I saw exactly zero people revived. And yes, ribs are broken. In most cases the person had been down for an unknown period of time, so likely had no possibility of surviving.
I remember one case of a middle aged who had collapsed at home. I was talking with him as he lay on the floor of his house, when he suddenly became unresponsive. We immediately began CPR and transported him to the hospital. He did not survive.
Yet there are people walking around today because of successful resuscitation.
How many are saved by the use of AEDs? Many schools, churches, and workplaces have these.
I presume Scott did not have the breakdown of success % vs. age, and that might have been helpful to know more about. Would there have been a success tipping point at age 45, or 55, or 68, or ???
Rick’s remark below about “hands only CPR” also raises the issue of whether adding the breath steps would have aided the survivors in their neurological outcomes. My CPR training from 15+ years ago claimed there was still considerable (or at least enough) oxygen available in exhaled breath to help the patient, but if chest compressions move the blood around that no longer contains enough oxygen, perhaps that is also not really helpful. I recall part of the goal was to keep the person viable until some form of AFIB electroshock was available?
I gather that generally (excepting accidents) our health declines slowly, and then rapidly (like bankruptcy). Minor muscle strains in your 30’s or 40’s; more aches into your 60’s, and then more visits to the doctor for various status checks (colonoscopy, bone mineral density, PSA, cholesterol, etc.) as minor complaints mount. Finally something more serious eventuates (hips, knees, cancers, back, stoke, heart attack, etc.), and that is when you are glad you have been saving for that final life expenditure of $100K to $200K. Plus, perhaps making payments for long term care insurance (which truth be told is probably not all that long term for most policy holders; and may only supplement but not fully cover all related costs)?
I would wish that Thelma and all the Thelmas would let their friends &families know their wishes, if that would have been her wish and not Scott’s to leave the earth that way. It sounds like maybe it might have been. I don’t know what the paramedics would b required to do without a written DNR order.
Yes, the success rate is quite disheartening (sorry), but I’ll still try. I might decide not to intervene if the victim’s circumstances leaned towards a poor quality of life outcome (e.g., a frail elderly person), but my nursing training would probably kick in anyway. (Obviously, a DNR order, or present Heath Care Proxy / PoA declining my assistance would be a different story.)
Steven is correct: doing compressions does take a lot out of the rescuer. For non-medical people, an option that decreases the number of steps, but increases the fatigue is “hands only” CPR. As the name implies, the rescuer only does compressions, pausing only to attached AED pads or to do a “pulse check”.
I have had only one save, and it was from doing rescue breaths after an airway obstruction. The ones where I had to do compressions were not successful.