Quote from unsaint77
I am going to type this written policy for you here. I saved the copy just in case.
"****** C.P.R policy and procedure
CPR will not be performed on any resident (regardless of code status) who is assessed as clinically expired by the folowing criteria, as determined by a licensed professional:
1. Absence of respiration
2. Absence of blood pressure
3. Absence of pulse
4. Absence of response to painful stimulus
a. Sternal rub - knuckle of fingers rubbed hard into sternum.
5. All above criteria must be present to determine resident is clinically expired.
Essentially, my facility prohibits me from doing CPR on a full code pt if they have no pulse.
I understand that in a normal setting, the only time chest compression is needed is in the scenario described in #4. And this policy prohibits that and directs me to call 911 instead. At best scenario, according to this policy, I can do rescue breathing if the pulse is present. But if the pulse stops in the middle of my rescue breathing, I am supposed to stop.
It sounds like my facility is not the only longterm care place doing this. (My whole building of over 100 residents and have not a single AED.) I suspect this is done because they have no financial gain from performing CPR, but potential legal problem. I know it is sad, but let's not dwell on ethics for now. By the samarithan law, I am supposed to apply my CPR skill to save people with no pulse. So, if I didn't do chest compression on a full code pt with no pulse, following the facility procedure, would my license be in jeopardy?
Maybe I am missing something, but I am pretty sure you got that wrong.
By your policy, no pulseless people get cpr. Anybody without a pulse will have no bp, respirations, response to pain, etc, therefore no CPR.
Under that policy, what patient would get compressions?
What on earth is the point of calling 911? They are going to attempt to resuscitate a patient that is far less viable because your staff was prohibited against providing the Standard of Care. The patient would have a better chance of surviving a pulseless arrest at a ball game.
I think this policy was written by somebody who doesn't really understand this stuff. One clue is having both criteria 4 and 5. A sternal rub IS painful stimlus. That's why it is done.
Maybe if you witness a pulseless arrest, you could get a family member to do compressions while you call 911. What a crappy position your employer has put you in.