questions about doing CPR

  1. Where I work, if someone is a full code (nsg home) we do CPR only if the cardiac arrest is witnessed.

    YOu wouldnt do CPR if they were found dead in bed.

    Is your policy the same?
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  2. 16 Comments

  3. by   bill4745
    No, everyone is coded, even if cold and stiff. (I work in a hospital.)
    It seems to me that if you fail to do CPR on a pt without a pulse then you are declaring death, which your nurse practice act probably does not allow you to do.
  4. by   tvccrn
    I don't think it matters where you work, a full code is a full code. That means if you find the person unresponsive and not breathing, no pulse, you start CPR.

    I would think your facility is setting itself up for legal action if a patient is full code and nothing was done for resuscitation.

    tvccrn
  5. by   ajaxgirl
    Quote from tvccrn
    I don't think it matters where you work, a full code is a full code. That means if you find the person unresponsive and not breathing, no pulse, you start CPR.

    I would think your facility is setting itself up for legal action if a patient is full code and nothing was done for resuscitation.

    tvccrn
    It's a nursing home, LTC facility. I dont know if I was clear about that.
  6. by   fultzymom
    At my facility we do CPR regaurdless. If someone is a Full Code, you have to try to resuscitate them. We have had nurses that refuse to do it but we just get another nurse to help et they have to deal with the consequences of that after the situation.
  7. by   wtbcrna
    Quote from ajaxgirl
    Where I work, if someone is a full code (nsg home) we do CPR only if the cardiac arrest is witnessed.

    YOu wouldnt do CPR if they were found dead in bed.

    Is your policy the same?
    I understand your facilities policy and I wouldn't tryto do CPR on someone that was cold/dead and probably stiff too. I used to work LTC and certain patients don't have to be checked on every couple of hours, so it could be the next morning 7-8hrs later before someone knew that they were dead.
    Now that I work in hospital the situation is totally different, but nursing homes are considered a patient's residence in a lot of ways.

    I can't get the mental picture out of my head of trying to do CPR on patient where rigormortis had already started to set in....
  8. by   RunnerRN
    People aren't dead until they're warm and dead......people who are stiff, however, are deader than dead (generally). If the patient is a full code and they're code and pulseless, I would still CYA and call a code. Just because your facility's policy says otherwise doesn't mean you're covered under the law.
  9. by   ginger58
    Quote from ajaxgirl
    Where I work, if someone is a full code (nsg home) we do CPR only if the cardiac arrest is witnessed.

    YOu wouldnt do CPR if they were found dead in bed.

    Is your policy the same?
    If someone is found dead in bed there is a hospital policy in place that allows the nurse not to do CPR.
  10. by   joyflnoyz
    Unless we have a signed Out of Hospital DNR form(a legal form sign by pt or RP, 2 witnesses and the physician) they are a full code.

    I really HATE having to do CPR, and when the families are emphatic about it, usually a gently detailed explanation changes their minds (my residents are usually in the 80's and 90's) Of course the explanation is given berfore CPR is necessary so we have the correct documents on the chart.
    Last edit by joyflnoyz on Feb 3, '07
  11. by   CapeCodMermaid
    Quote from bill4745
    No, everyone is coded, even if cold and stiff. (I work in a hospital.)
    It seems to me that if you fail to do CPR on a pt without a pulse then you are declaring death, which your nurse practice act probably does not allow you to do.
    If the resident's code status is anything but DNR, we initiate CPR if we find them pulseless...we try really hard not to let things get to that point and ship them off to the ER before they get that bad.
    P.S. The nurse practice act in Massachusetts allows RNs in a skilled facility to pronounce people dead.
    Last edit by CapeCodMermaid on Feb 3, '07 : Reason: left some good stuff out
  12. by   tvccrn
    Quote from ajaxgirl
    It's a nursing home, LTC facility. I dont know if I was clear about that.

    You were clear. It still doesn't matter..full code means full code. In the nursing home, in the hospital, in the ambulance. Full code = full code.

    I'm not saying is perfect, if you know they are dead from the condition it's not goona help much. But, they are a full code and that means you do everything until a person who is, by law, able to say stop says stop.


    tvccrn
    Last edit by tvccrn on Feb 3, '07
  13. by   wtbcrna
    Quote from tvccrn
    You were clear. It still doesn't matter..full code means full code. In the nursing home, in the hospital, in the ambulance. Full code = full code.

    I'm not saying is perfect, if you know they are dead from the condition it's not goona help much. But, they are a full code and that means you do everything until a person who is, by law, able to say stop says stop.


    tvccrn
    Having worked in LTC/Prison/ICU/ER and I can tell you that it does make a difference. You need to able to defend your actions based on objective assessment findings and get the provider on the phone ASAP to back you up, but there are reasons for this policy and I am sure many LTC facilities have done it this way for years w/o legal difficulties.

    By the way tvccrn...What does your screen name mean? I am just curious I got my LVN from community college named TVCC.
  14. by   tvccrn
    Quote from wtbcrna
    Having worked in LTC/Prison/ICU/ER and I can tell you that it does make a difference. You need to able to defend your actions based on objective assessment findings and get the provider on the phone ASAP to back you up, but there are reasons for this policy and I am sure many LTC facilities have done it this way for years w/o legal difficulties.

    By the way tvccrn...What does your screen name mean? I am just curious I got my LVN from community college named TVCC.

    What actions would you need to defend. If you start the code when you find someone down, you are doing what the patient wants. If you don't because whatever reason, then I can see needing to defend your actions.

    The tvcc is from Trinity Valley Community College in Athens, Texas. Is that where you graduated from?

    tvccrn

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