CPR after rigor mortis - page 9

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   bobnurse
    Quote from healinghandsrn
    i know it is very senseless.....but my ltc facility is telling the rn's now they can only pronounce death if pt is a dnr.....but if a full code no matter what condition cpr has to be started....did u ever hear of such a thing?
    well acls guidelines state that certain measures should take place prior to calling a code. intubation, first line meds, and differential diagnosis. so just doing cpr for 10 minutes doesnt cut it. (no rigor mortis). in ltc, you cannot provide that, so it makes sense not to allow you to pronounce a full code patient with only minimal bls support (most ltc are without aed's as well).

    in many states, although emt's cannot pronounce, they can radio a physician after all attempts have failed, intubation and meds given, and the doc will call it. they then leave the patient at the ltc center versus transporting a asystole patient with no chance of survival.
  2. by   KlareRN
    I have worked in management in long term care for several years and every facility I have worked in has the same policy:
    If a person is not a DNR- you are to initiate CPR and you send them out 9-1-1 no matter how you find them unless:
    -Obvious lividity is present
    or
    -they are decapitated (God help us in LTC if this is EVER the case!!!)

    These are the only 2 reasons policy has allowed a licensed individual to make the determination that coding someone is not necessary. Doesn't really give us much credit does it?!
  3. by   Jo Dirt
    That passed ridiculous a long time ago. I would never even attempt that scene. Let them fire me over it, I'd make sure that story was plastered in as many papers as I could.
  4. by   Blackcat99
    :chuckle I'm not going to do CPR after rigor mortis period. I don't want to go to jail for abusing a corpse.
  5. by   leslie :-D
    Quote from Blackcat99
    :chuckle I'm not going to do CPR after rigor mortis period. I don't want to go to jail for abusing a corpse.
    plus you try bending that head back... :chuckle
  6. by   imperial
    Quote from KlareRN
    I have worked in management in long term care for several years and every facility I have worked in has the same policy:
    If a person is not a DNR- you are to initiate CPR and you send them out 9-1-1 no matter how you find them unless:
    -Obvious lividity is present
    or
    -they are decapitated (God help us in LTC if this is EVER the case!!!)

    These are the only 2 reasons policy has allowed a licensed individual to make the determination that coding someone is not necessary. Doesn't really give us much credit does it?!

    I am somewhat confused. Doesn't DNR mean just that "DO NOT R">>>>>>>>>>> meaning no CPR? If so, then why have a DNR order? Of course, it has been sometime since I was in LTC, so pls explain. I would also think that this would be somewhat of a liability situation for the SNF if the family members are under the impression that DNR means just that....?
  7. by   ProfRN4
    Quote from Blackcat99
    :chuckle I'm not going to do CPR after rigor mortis period. I don't want to go to jail for abusing a corpse.
    :yeahthat:
  8. by   ProfRN4
    Quote from KlareRN
    If a person is not a DNR- you are to initiate CPR and you send them out 9-1-1 no matter how you find them unless:
    -Obvious lividity is present
    or
    -they are decapitated (God help us in LTC if this is EVER the case!!!)
    Dumb question, but can one be 'livid' without rigor mortis??
  9. by   bobnurse
    Quote from bonemarrowrn
    Dumb question, but can one be 'livid' without rigor mortis??
    I believe you can have levidity without mortis.....or before it in many situations
  10. by   NurseFirst
    Quote from bobnurse
    I believe you can have levidity without mortis.....or before it in many situations
    To the poster who said you need a 'script to get an AED. This is no longer true. You can buy them off of Amazon.

    As far as rigor mortis and lividity is concerned, I'm not sure what color I would want someone's skin to be after lividity went away . What I mean is, rigor mortis is a more time-limited phenomenon, I believe; it will definitely set in before putrefication. I suspect lividity would not go away until putrefecation
    set in; even if the blood breaks down (the pooling of which in dependent parts is what causes lividity), there is nothing to take the heme (i.e., red or purpleness) away. I'm pretty sure coroners/medical examiners can tell the position the person died in for quite a while, which is the information that lividity provides.

    NurseFirst
  11. by   ProfRN4
    Quote from bobnurse
    i believe you can have levidity without mortis.....or before it in many situations
    so you don't even have to wait for mortis???
  12. by   monroea23
    At the LTC facility I used to work at in Iowa we did not do CPR on residents who were full codes unless we saw the resident go down. If we found them dead we did nothing.
  13. by   jeanrnurse
    Let's use a little common sense here.

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