Should a nurse perform CPR to someone outside of the healthcare setting?

[jjones1728]

Should a nurse perform CPR to someone outside of the healthcare setting? Is it safe?

[jjones1728]

Should a nurse perform CPR to a person outside of the healthcare setting? Is it safe for the nurse?

[jonesb1984]

As nurses we put others before ourselves everyday. I would take precautionary methods if I could but I would have to help.

[ComeTogether, LPN]

I don't understand how anyone who knows CPR could possibly refuse to perform it on someone who wasn't a DNR and needed it. Period. Nurse, handyman, cop, checkout girl, what have you.

[loriangel14, RN]

Why on earth would you not? Would you stand there and do nothing?

[akulahawkRN, ADN, RN, EMT-P]

When you are outside of your normal work environment, and you come across someone who needs CPR, generally speaking you are protected by the Good Samaritan laws of your state. What that means is that unless you know for sure that someone is a DNR/No Code, you can start CPR and you will generally be protected against lawsuit, even civil suit, unless you do something that is grossly negligent. The only thing that I would add to that is not to exceed the care given by someone trained in first aid. The laws/regulations of your state may allow a nurse or other advanced level provider to provide some advanced level care, most probably will not. If you exceed that level of care that they authorize, you will be at risk for lawsuit. From my understanding if you provide care at a level no greater than first aid, you will be fine. That does not mean that you cannot assess the situation at the level of training you have, but, the care you give should not be any higher than that of basic, or even advanced first aid.

When I am working as a paramedic, if I go off duty and I come across someone in need of help, I am safest in providing care at a level no greater than that of the basic EMT. That does not mean that I cannot assess at a paramedic level, rather I must (and in some cases required to) provide care at the EMT level. With nurses, the basic idea is the same. You have a lot of knowledge and experience in providing rather high level care, but, when you are not working as a nurse you must restrict your care to that of essentially an EMT. That is, for all intents and purposes, advanced level first aid. Stick to that guideline and you will probably never have to worry about seriously being sued. Yes, someone could try to sue you, but the Good Samaritan laws in your state should provide protection against that lawsuit.

[elkpark]

Count me out unless I am required to because I'm at work, or, outside of work, it's someone with whom I have an existing relationship (and care about ... :)). Everyone else is on their own as far as I'm concerned. CPR is pretty much a joke unless it's done under perfect, laboratory conditions, using perfect technique. Even than, it's not terribly effective. IMO, most of us put waaaay too much faith in it.

[akulahawkRN, ADN, RN, EMT-P]

Count me out unless I am required to because I'm at work, or, outside of work, it's someone with whom I have an existing relationship (and care about ... :)). Everyone else is on their own as far as I'm concerned. CPR is pretty much a joke unless it's done under perfect, laboratory conditions, using perfect technique. Even than, it's not terribly effective. IMO, most of us put waaaay too much faith in it.

When done properly, good CPR provides only about 30% of the normal blood flow. That is true. Internal cardiac massage can reach 80%... but I don't know of anyone that's normally willing to do a thoracotomy "off the clock."

[traumaRUs, MSN, APRN]

Sure and with the new guidelines that say when you are doing bystander CPR, all you do is compressions anyway, why the heck would it not be safe?

[elkpark]

When done properly, good CPR provides only about 30% of the normal blood flow. That is true. Internal cardiac massage can reach 80%... but I don't know of anyone that's normally willing to do a thoracotomy "off the clock."

(That reminds me -- many years ago, when I was in nursing school and all hepped up about having learned CPR for the first time, my father, a physician, took me aside to tell me in all seriousness that, if he ever fell over dead in front of me, I should not waste any time fooling around with CPR, but just cut him open and do direct cardiac massage. He explained to me in great detail (and pointing to landmarks on his torso) exactly where and how I should cut and exactly how to do the direct massage. The whole conversation was practically traumatizing. :) He was always openly scornful of CPR, and used to say the only thing it was good for was to give the staff nurses on the floor something to do to feel useful while they were waiting for the code team to arrive -- he considered starting CPR out in the field idiotic. For better or worse, I've inherited his views. :) )

[MunoRN, RN]

Count me out unless I am required to because I'm at work, or, outside of work, it's someone with whom I have an existing relationship (and care about ... :)). Everyone else is on their own as far as I'm concerned. CPR is pretty much a joke unless it's done under perfect, laboratory conditions, using perfect technique. Even than, it's not terribly effective. IMO, most of us put waaaay too much faith in it.

So percentage-wise, how ineffective do you consider CPR? Your description sounds like you are referring to a success rate of well under 1%.

[HouTx, BSN, MSN, EdD]

I respectfully differ with some of the PPs.

Success rates for field resuscitation vary according to the circumstances. Near drowning, electrocution, asystole due to sudden chest impact (think soccer ball), etc.... all are situations where CPR is much more effective than trying to re-animate the typical obese over-50 restaurant MI.

Me? I would NEVER opt-out of CPR on a child, but that's just me.