CPR - pro or con

[Glenn E. Meyer]

Interesting article on CPR: https://www.newyorker.com/news/the-w...n-harms-of-cpr

Discusses the use of it in various scenarios such as emergency heart attacks, hospitalized patients at the end of life, outcomes %, etc.
I've read these sort of analyses before and had a CPR class, tac first aid class. Where I worked had AEDs on the walls in most buildings. Side bar - one place had evac chairs folded up to get nonmoving folks out, never saw them elsewhere. Some bleed out kits are appearing. Side bar asked the USPSA folks if we had an appropriate kit available for matches - answer - DUH. TX, we had such and even a show of hands at some matches for trained folks. Some of the NYS folks are emergency personnel, so maybe they were up to speed. One guy had a clear kit on his belt, asked him about it and he was an engineer. Go figure.

Anyway, I did see a colleague go down at work and the campus PD get to him in minutes and attempt CPR but he was just gone. It did look pretty brutal.

For those in the fields, thoughts on this?

[HCM]

Interesting article on CPR: https://www.newyorker.com/news/the-w...n-harms-of-cpr

Discusses the use of it in various scenarios such as emergency heart attacks, hospitalized patients at the end of life, outcomes %, etc.
I've read these sort of analyses before and had a CPR class, tac first aid class. Where I worked had AEDs on the walls in most buildings. Side bar - one place had evac chairs folded up to get nonmoving folks out, never saw them elsewhere. Some bleed out kits are appearing. Side bar asked the USPSA folks if we had an appropriate kit available for matches - answer - DUH. TX, we had such and even a show of hands at some matches for trained folks. Some of the NYS folks are emergency personnel, so maybe they were up to speed. One guy had a clear kit on his belt, asked him about it and he was an engineer. Go figure.

Anyway, I did see a colleague go down at work and the campus PD get to him in minutes and attempt CPR but he was just gone. It did look pretty brutal.

For those in the fields, thoughts on this?

I am 0-2 on CPR on adults.

The CPR successes that I am personally aware of all involved children who were deprived of oxygen. One being a boy, who was buried by a cave in while playing at a construction site, and the other being a girl who was found following facedown in a hotel pool.

AEDs have a SIGNIFICANTLY higher success rate in adults.

[bofe954]

CPR is kind of brutal.

I think the important thing to remember is that if you are doing CPR on someone, they have no pulse, they are dead anyway, right?

If they are pulseless because of an arrhythmia, CPR and an AED will help, they could be pulseless for a multitude of other reasons and CPR will not help. CPR is also is skill dependent, if it isn't done well, it doesn't help (as much). You can think of it less as an attempt to cure something and more as an attempt to keep someone's brain oxygenated long enough for them to get attention from someone who can figure out what's wrong with them and fix it.

If you see someone go down at the mall, at a sporting event or work or whatever, you might as well just try CPR. The odds are against you, and I wouldn't look at it as "losing" or being 0-2 or whatever if it doesn't work. They were dead before you started.

The article is paywalled for me but it seems to be more pointed at CPR for codes in the hospital which is a totally different thing.

[MGW]

Are there any affordable options for home AEDs? Affordable and reliable that is.

[JCS]

I work for an agency that has one of the highest cardiac arrest save rates in the country. There’s one thing that’s almost always shared with the saves. They are usually witnessed arrests and had good bystander cpr started immediately.

It’s obviously way more complicated than that. But good cpr is critical.

As someone mentioned, they’re already dead. You can’t control what type of rhythm they are in, whether it’s shockable or not. But if they can be saved, they need good cpr fast.

[Borderland]

Isn't a layman's CPR, say on the street, a lot different than in a hospital. Don't they have crash carts in hospitals with trained personnel to use them?

My wife has a do-not-resuscitate order on her medical directive. I don't.

[Totem Polar]

We just had a very public CPR save at the state U here; running start 16 year old student cardiac arrest in class saved with CPR by another, lifeguard-trained, college student. A very good example of making someone less dead. Age and speed of treatment may well have contributed to the happy outcome; I’ll let the experts (not me) field that one.

[Glenn E. Meyer]

Not an expert certainly. The recovery may be due to the stoppage being some kind of conduction, timing failure and not a structural defect that blows out some vessel. That is the case in the young? My cardiologist was going over with me, the major sites of failure and blockages that are unrecoverable unless you are on the table.

The article did focus on the hospitalized, really sick, organ failure folks. Sigh, such things to think about. I have a medical instruction letter.

[Stephanie B]

I've had a couple CPR classes, none recently. I'd still give it a go. My feeling is like others expressed: They're already mostly dead. My doing CPR's not going to make things worse.

[BillSWPA]

Very different situation, but when my son was born, he was not conscious or breathing. At one point his pulse dropped to 40 bpm. He was given chest compressions by one nurse while others suctioned out his airway and supplied him with oxygen (they had an oxygen source right in the delivery room which did not require manual breaths). They got him conscious, breathing, and with a normal infant pulse within about 4 min.