My TCU CPR policy - page 4

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... Read More

  1. by   jelly221,RN
    Quote from Enthused_Nurse2B
    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.
    At my place, charge nurses in critical care can call it.
  2. by   Penelope_Pitstop
    Quote from tothepointeLVN
    I would have to believe that policy refers to someone that is not only merely dead but really most sincerely dead. When someone is most sincerely dead you know it.
    But what if the coroner from Munchkinland is not available?

    Anyway, I am really confused by this policy. Not sure how I stumbled upon this thread...did we ever clarify the policy?
  3. by   sauconyrunner
    I'm curious if it ever got clarified either!
  4. by   DixieBelle7
    In regards to Enthused RN's statement that only MDs and Paramedics can pronounce..

    In Texas an RN can pronounce. I am a Certified Hospice and Palliative care RN..... I pronounce patients all the time. I even have to go into LTC facilities to pronounce if the facility has no RN on duty (which is very common at night)....
    Last edit by DixieBelle7 on Feb 14, '15 : Reason: added clarification
  5. by   klone
    Quote from AnonRNC
    "Obviously dead" needs to be defined? How can you tell the difference between 3 minutes and 30 minutes dead?
    If I'm 3 minutes dead, please do not try to revive me.

    The only time CPR does any good is when the arrest is witnessed. I think they need to revise their policy to state that it's acceptable to do CPR in that instance. Other than that, I don't think the policy is horrible (and I do think they should get an AED).

    Gah! Zombie thread (fitting, considering the subject matter). I always fall for the zombie threads!
  6. by   nurseprnRN
    Did you read zookeeper's comment? "a few nursing homes don't do CPR, they call 911." That is exactly what I mean. So, my facility is not the only place with this horrifying policy.
    There is a long thread in here somewhere about a woman resident in an ALF who went there specifically because she did not want to be resuscitated when her time came, and her family agreed with her. The facility had a policy that anyone having a cardiac arrest would not receive CPR or BLS from staff, and they did not require staff to be certified in BLS. This was a positive feature that led to her and her family choosing it.

    So, when she died at the lunch table and somebody let her go, somebody else went apepucky and called 911 and it hit the national news and there was considerable outrage over this place not giving CPR. It took days and days for the furor to die down enough that anyone bothered to quote the family, and the debate on AN raged on for a long time about how cruel and horrible this was. People mean well, but they are wrong on this one.

    So. If your facility has that policy and the family is aware of it at admission, I don't see what your problem is. It's not horrifying at all. It's death. There are far, far worse things, and I've seem them, and among them are doing CPR on an old person who gets yanked back from a peaceful ending by having her ribs cracked, her sternum separated, a big tube forced down her throat, big IV lines jammed through her delicate skin, and all for naught to die in a few hours or days anyway, because the survival rate for CPR out-of-hospital arrests is like 6%, if that, and way less when you separate out for age, cause of arrest, and premorbid conditions. She suffers, her family suffers, witnesses suffer, and staffers suffer. This is not beneficence, which is one of our duties to patients. You can look it up.

    Recalibrate, please.