CPR after rigor mortis - page 6

Hello All, Do u know where I can find information referring to Long term care scope of practice for RN's? What is the policy on starting cpr after rigor mortis set in? Thank you:)... Read More

  1. by   leslie :-D
    Quote from renerian
    If there is no DNR in place and you find a dead patient and don't start CPR, I am sure the families would line up to sue nice and quickly.

    renerian
    even after rigor mortis has set in????
  2. by   Forcemaster
    Technically as soon as the heart ceases electrical activity, a person is dead. Now this doesn't mean that we can't bring them back using ALS techniques, and so we try our best...

    But what does it mean to do CPR on someone in whom has been dead a while? For a start, your chances of a successful recovery are somewhere in the region of winning the lottery two times in a row (or... pretty darn small!). But unless you can pronounce a person dead, then is it unreasonable to attempt to try, especially when you might have legal ramifications from relatives? I would always try for CPR in a patient on the ward unless they have a DNR order against them or there were extenuating circumstances. After all, i would prefer to say to the relatives (and god forbid a judge) that "...we did everything we could" rather than "...we did nothing except call the morgue":stone
  3. by   Havin' A Party!
    Quote from CapeCodMermaid
    ... was told by the ED that it opens us up for lots of liability...
    Have heard this also, but in non-healthcare related locations (e.g., shopping centers, etc.).

    The rationale is that if it's not a prescripted piece of equipment on those premises, then having it there will presume professional standards for its use and, hence, potential liability.
  4. by   Antikigirl
    I am with you forcemaster! It is so much better to say you tried something than having to tell a loved one that just had a loss..."I called the county coroner...".

    Renerian...you are right, but I can't tell you how many times, despite the DNR status family screams at me to "DO SOMETHING!". I remind them of the status and they look at me like I was Satan or something...like I care more for a piece of paper than a person...it is a trickier situation than just not doing something...happens when emotional levels partnered with seconds counting hit head on!

    A nursing friend of mine, also in assisted living had to perform CPR on an obviously dead man the other week. He had died in his sleep obviously..was stiff as all get go, gone for hours...but the wife insisted they call 9-11 and get CPR efforts underway till they arrived. She said she felt like a fool, and knew the paramedics would certainly think so...and I guess they did till they met the wife! LOL! They put on the EKG and finally she would listen to reason when she saw the flat line and heard them say "there is nothing that could have been done, he must have passed peacefully in his sleep".

    Here was the trick of why CPR was done...legal reasons and a lot of compassion...a spouse (spouse or family POA only) can okay the use of CPR in a DRN patient that can not speak for themselves..(but they can not say don't treat..that becomes a conflict of interest...I have run into this time and time again with relatives or spouses screaming at me to stop CPR when there is no DNR present..I can't..they have no say at that point...but I also have been told TO do CPR by spouses with DNR in place and I must..but for me they were recently arrested in my own sight..whew!).

    It all depends on situation...sometimes it is simply done for compassion and to help the loved one cope (ie the "we did everything we could")...and other times it is no problem and you just go on with your task of calling whom you need and get back to our jobs of dealing with the demands of the living...
  5. by   bobnurse
    Quote from LarryG
    Have heard this also, but in non-healthcare related locations (e.g., shopping centers, etc.).

    The rationale is that if it's not a prescripted piece of equipment on those premises, then having it there will presume professional standards for its use and, hence, potential liability.
    You no longer have to have a prescription for the heartstart AED and another brand, and soon any brand im sure.
  6. by   Antikigirl
    Rx for an AED???? Never heard of this! We don't need Rx for AED's here..they are in most if not all of our malls statewide, police are carrying them now (slower to get them all...but they are becoming standard for their cars)...most airlines have them too. It is a blessing!

    I also live in a very high tech industry area where most larger tech corps have them in every building, every floor of their huge facilities..this will be common practice soon! YEAH!~

    Well...guess it has to do with the fact that I live near where the very first portable defib was invented, and made..and improved over the years (you should see the first one..looks like a medievil torture device!!!!!). AED's are considered excellent PR in any place here...so places get them . I can go with that..make it trendy..LOL!
  7. by   lahunt
    [As a Advanced Cardias Life Support Certified RN, if there are signs of death, i.e. mottling, rigidity, etc. then CPR is not to be started. It would just be futile. My charge nurse ordered us to start CPR on this patient that had been dying all night. The primary nurse had been calling the cardiac surgeon, to be told there was nothing that could be done, but.... he would not make him a DNR!! It would probably affect his survival statistics. Who knows. Well, a code was called and the doctors took one look at him and said stop! Thank goodness. It was awful, so now I know different. QUOTE=healinghandsRN]Hello All, Do u know where I can find information referring to Long term care scope of practice for RN's? What is the policy on starting cpr after rigor mortis set in? Thank you[/QUOTE]
  8. by   vickster
    Quote from healinghandsRN
    Hello All, Do u know where I can find information referring to Long term care scope of practice for RN's? What is the policy on starting cpr after rigor mortis set in? Thank you
    Good Lord! I've never heard of anything so bloody stupid!!!!
    Tell your DON that by the time somebody has rigor it is miles TOO LATE and way to disgusting to do CPR!!
    1. pointless
    2. should have advanced directives that state, "CPR when death is witnessed" ie sudden cardiac events
    3. needs to put in a policy that all residents are checked on at least hourly, even through the night, so that you never find someone with rigor. What if someone is laying on the floor with a broken leg for that long???

    What if that case ends up on the coroner's desk? He's going to think that you are not monitoring your residents and that you've all lost your minds for starting CPR! Get it in writing, and make your advanced directives MORE SPECIFIC. It does not have to be black and white, CPR or no CPR.
  9. by   vickster
    Quote from Salty
    Only if the patient's name is Lazarus.
    Good one!
  10. by   Reborn
    As unbelievable as it is, I actually saw this in a 200 bed hospital.
    It was on the med-surg floor, and buddy roe's head nor feet would not touch the bed when the bed was flattened, from being in a hi-fowler's dead for ????(how long????who knows) :smackingf
    Not only that, but the moron's who were coding the poor stiff, were running around in the usual hand trembling, wild-eyed, chicken with heads cut off mode that they ALWAYS ran codes with.
    (1989, ACL what?)
    Don't know if it's changed, Thank God for making a way out of hell for me.
  11. by   eyesonly
    Quote from healinghandsRN
    Well, our nurse educator is teaching that u start cpr on anyone who is not a dnr "NO MATTER WHAT" She said "I don't care what anyone thinks how long they passed, if no DNR start cpr. Personally that does not sound correct to me. But If I am going to stay in this type of setting I need to learn the regulations for myself and not just take someone elses word for it.
    In our state, you get an order from the MD a telephone order, stating attempts would be futile, do not start CPR. Some states require a paramedic to do this. If they are in rigor, I would only bag them, til medics arrived. You wouldn't be ableto compress the heart anyway.
  12. by   Havin' A Party!
    Quote from bobnurse
    You no longer have to have a prescription for the heartstart AED and another brand...
    Hey there, Bob. Believe you're right about not needing a "script" for some of this equipment.

    I wasn't addressing that point though. By "prescripted," I meant not required by the rules, regs, laws, etc., applicable to the premises mentioned. That is, most land use / zoning regulations and directives that I'm familiar with don't mandate AEDs for malls, shopping centers, and the like. That may change down the road.
  13. by   BabyRN2Be
    Quote from bobnurse
    You no longer have to have a prescription for the heartstart AED and another brand, and soon any brand im sure.
    Yes, actually I found one the other day on Amazon.com. An AED without a prescription. My husband, unfamiliar with how these things work, said, "I can see a bunch of high school kids having a grand old time with one of those."

    I can see how they would be helpful, and from what I understand, they are supposed to be foolproof. But fools often do find ways around safety mechanisms. It would scare me to think if one was used in a torture situation.

    (BTW, this is my first time back in a LONG time. Lots of cool, cute emoticons)

close