CPR for the frail and obese

  1. 0
    I've been reading a thread here about CPR (started by Rags2RichesRN) but I have a slightly different question than hers. My question is that I, too, am a new nurse and although I, too, took the American Red Cross CPR program last year, I really don't feel qualified to save lives in the LTC facility where I work. Most of these residents are already frail and I could easily injure them, and some are morbidly obese and there's no way I could do thrusts on them. My feeling is that there should be special CPR techniques taught for these types of patients. I just started working 6 weeks ago and I'm really worried that when I'm the only LPN on the unit that someone will choke or otherwise need life support quickly. What do you suggest I do? Just call the supervisor and hopes she gets to my unit really fast? Your thoughts will be appreciated. Thank you.
  2. Get our hottest nursing topics delivered to your inbox.

  3. 25 Comments so far...

  4. 21
    Quote from onthemark
    I've been reading a thread here about CPR (started by Rags2RichesRN) but I have a slightly different question than hers. My question is that I, too, am a new nurse and although I, too, took the American Red Cross CPR program last year, I really don't feel qualified to save lives in the LTC facility where I work. Most of these residents are already frail and I could easily injure them, and some are morbidly obese and there's no way I could do thrusts on them. My feeling is that there should be special CPR techniques taught for these types of patients. I just started working 6 weeks ago and I'm really worried that when I'm the only LPN on the unit that someone will choke or otherwise need life support quickly. What do you suggest I do? Just call the supervisor and hopes she gets to my unit really fast? Your thoughts will be appreciated. Thank you.
    I've done CPR probably 100 times (20 years of EMS) and ribs fracture almost every single time, of people of every size and shape. Remember, you'll need to vary your chest compressions in strength so you're depressing the # of inches that you're supposed to. It won't take much for your 90 lb LOL and a whole lot more for your 400 lb pt re-habbing for his hip replacement.
    I can only think that calling your supervisor and hoping she gets to you quick will not endear you to her. CPR is a skill you must know as a nurse and even more importantly, be willing to perform if and when you are called to do so.
    michelle126, LoveMyBugs, canoehead, and 18 others like this.
  5. 28
    You can't hurt the dead. Do the best you can.
    michelle126, AreEn17, canigraduate, and 25 others like this.
  6. 7
    haha biff.. my ACLS instructor said the same thing.. If you do nothing they will die so compared to that, you can't hurt them anymore.. Ribs will break more times than not if you are doing compressions the way you were taught...
    canoehead, Otessa, VivaLasViejas, and 4 others like this.
  7. 3
    You may be shocked at what you can do one the adrenaline starts pumping!
  8. 4
    If you're not breaking some ribs, you're not doing it right. Don't worry so much about "hurting someone." If you have to do CPR, they're DEAD. Either you'll revive them with your amazing chest compressions or you won't. And often the outcome isn't in your hands at all. Sometimes the ones you think will make it, won't. And the ones you're sure are headed for the pearly gates pull through. Either way, you just have to go at it full throttle, no holding back. Sometimes you have to hurt people to help them get better.
    Otessa, casi, VivaLasViejas, and 1 other like this.
  9. 1
    I am quite small and I've cracked ribs while doing CPR in the ER but when it's life or death you have to do what you have to do. Use less force when doing compressions on frail individuals. As far as the larger patients go I will usually ask a male to step in or if none are available I have knelt up on the bed next to the patient and used my whole body weight when doing compressions.
    Biffbradford likes this.
  10. 2
    Most of the really frail ones in LTC are DNR anyway. Make sure you know their code status before you save them.
    applewhitern and Ashley_RN like this.
  11. 0
    Quote from ertech2088
    [color=silver]i am quite small and i've cracked ribs while doing cpr in the er but when it's life or death you have to do what you have to do. use less force when doing compressions on frail individuals. as far as the larger patients go i will usually ask a male to step in or if none are available i have knelt up on the bed next to the patient and used my whole body weight when doing compressions.
    yup, i've seen that. hop up there if you have to ... if you're in the right unit, and it's your lucky day, you just might get a ride right into o.r. "watch out for the door ... duck!"

    i've seen that. one of those 'never forget' events.
  12. 0
    Although I appreciate your reminding me to check their DNR status, that fractures will be probable, and also that it's apt to not work with them but a try is better than nothing, I still don't see how I can do this when most of the patients are in wheelchairs. Do I ask the aides to help me get them out of their chair and laid down on the bed/floor, and then proceed with CPR while I ask another aide to call the supervisor? Do I keep my breathing mask with me at all times for the 2 rescue breaths? I have never even taken the mask to work with me but if the CPR is my responsibility then maybe I should.

    I'm sorry to be such a newbie at this and really appreciate any advice and tips you can pass on to me. Thanks!!!


Top