My TCU CPR policy - page 3

Even for full code pts, my TCU CPR policy is not to do CPR if the pt is determined to be dead. The TCU protocol qualification for being dead is no pulse and no response to stimulus. (a person without pulse will not respond to... Read More

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    How would you possibly know that the person had passed the point of no return? If no pulse present, chest compression must begin.

    And what do you mean by "clarify?" I typed the policy word for word.

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  2. 7
    That policy is scary, and frankly, the nursing home is opening themselves up to a lot of liability if a full code patient arrests and compressions/intubation/code drugs are not initiated per their wishes. As another poster asked, are family members and patients made aware of this policy? The policy basically says that all patients admitted, regardless of their wishes, become DNRs upon admission. I have not heard of any healthcare facility having a policy like this and can't fathom the facility's reason for having that policy. You seem to think it's a money issue, but it seems to me they would make more money from living, resuscitated patients than from dead ones.
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    Obviously dead, then CPR is only going to accomplish giving the person doing compressions their cardio workout for the day.
    But a flat "if they don't have a pulse, don't do CPR" rule is the dumbest policy I've ever heard. If they had a pulse, you wouldn't be doing CPR anyway.
    I think the person who wrote the policy was trying to go for the "Don't do CPR if they're obviously dead" rule and ended up inadvertently making everyone a DNR.
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    "Obviously dead" needs to be defined? How can you tell the difference between 3 minutes and 30 minutes dead?
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    I guess I do not see the point of such a policy. The whole point of CPR is to keep the blood pumping to the vital organs, hoping it the heart will restart. I have never heard of such a policy. If this is truly the practice I would look elsewhere for employment because I would think your license could be in jepardy I know it would be in Ohio.
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    Quote from unsaint77
    And what do you mean by "clarify?" I typed the policy word for word.
    I believe that I am thinking the same thing as the person who asked you to clarify--sorry if I am putting words in someone's mouth. The policy, as written, appears to me mean no CPR ever. Before you stand there and not do CPR on a witnessed arrest, I think clarifying the policy is good idea.

    In addition, I think "the point of no return" does need to be better defined, because not having a clear policy on when to intiate CPR and when not to intiate is going to create problems if someone chooses not to intiate just because that RN felt it was a futile effort.
    DeLanaHarvickWannabe likes this.
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    Quote from Esme12
    I am uncomfortable with this.....that policy essentially says let everyone die. PM me their name and I'll report them. At least there will be an investigation to find out this is true and understood properly. This is a TCU not a hospice unit.....I'd go to the media now. This policy is a problem.

    NO AEDs? Wow this place needs to be closed down. go to the joint commision web site and file a complaint. Here is the link. The will investigate. Call the state.

    Thanks for saying this.

    I fully support you passing on the information to Esme12 so she can report this.

    Absolutely disturbing
    BrnEyedGirl and Enthused RN like this.
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    Quote from unsaint77
    ... as determined by a licensed professional.
    Maybe they define licensed professional as a MD or paramedic? Those are really the only 2 who can legally declare someone dead, right? As a previous poster said, I would clarify with your facility on what exactly they mean and talk through some scenarios with them. For me, I would start CPR until a MD or paramedic gave the declaration.
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    Having just gotten my ACLS certification, this greatly disturbs me. Per ACLS guidelines, you do not attempt compressions only if there is a DNR or rigor mortis present. In my facility, we attempt resuscitation regardless of rigor mortis being present unless there is a DNR.
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    Quote from unsaint77

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