Should a nurse perform CPR to someone outside of the healthcare setting? - page 3
by jjones1728 11,196 Views | 48 Comments
Should a nurse perform CPR to someone outside of the healthcare setting? Is it safe?... Read More
- 0Mar 27, '13 by vintagemotherThis conversation is causing me to consider one of my nursing school's policies, for the umpteenth time. In my school students aren't allowed to assist with feelings in residents rooms. I thought that was strange because from CNA school to my job as a 1:1 CNA in a hospital, I assist with feelings.
However, what's more perplexing to me is that I just found out students aren't allowed to feed anyone at all at the LTC facility even in the dining room. This far, we've been told the reason is that the person may need CPR and our school doesn't want us to use it.
I'm having a hard time imagining how/ why a school would require CPR with BLS and then tell us to stand and watch a resident choke and possibly die.
Is liability really that big of a concern? Or am I missing something?
- 0Mar 27, '13 by SuzieVNRelevant post- more so with that 'nurse' that watched that old patient die, and did nothing, in the place in CA that was reported around the globe. I suspect she's in for heartbreak from the CA BON. Anyway- from my latest readings, now, CPR is to be hands on only, with no breaths attempted, because the latest research from the AMA, and the like, have shown that circulation is the sole key to survival? But also, it was reported that the success rate of CPR was at best 15-18%? I'm old school, to the point of one state having determined: Do NOT attempt CPR, unless you personally witnessed the arrest- because you do not want to resuscitate anyone that may already have suffered brain damage from lack of oxygen...since they will be resuscitated, but into a vegatative state?
- 1Mar 28, '13 by akulahawkRNGenerally speaking, CPR out of hospital has a very low survival rate. However, it's better than zero and if it's done right, you can stave-off brain damage. Like I posted earlier in this thread, flow rates are only about 30% of normal. The push to CAB instead of ABC was to drive home that if we're doing CPR, minimal interruptions in compressions is desirable and it takes a while to bring circulation back up after a pause. So, once you start, don't stop for long, if at all. If you're lucky enough to get the person intubated quickly enough, do continuous CPR once the tube's in.
Would I do CPR "off the clock"? Yes. I have and I'll continue to do it, knowing how effective it is. Why? As poor as CPR is, I'm giving that person the best chance I possibly can. Since we don't do thoracotomies to do internal cardiac massage, it's what we're limited to. I would think long and hard about starting CPR on a trauma victim though.
- 0Mar 29, '13 by SuzieVNQuote from elkpark(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. )
Cute post. BTW- I am a "DNR", but it's not tattoed on my chest, yet- so think twice about a lawsuit if you get too close to ME. In my view of myself- I coded for a reason, and it's time to 'kiss the sky'~
- 1Mar 29, '13 by akulahawkRNQuote from SuzieVNJust make absolutely certain that you've got the right paperwork or appropriate substitute (like a recognized medallion) on your person at all times. Without the correct documentation, you will likely be resuscitated. The lay rescuer typically has NO idea what a DNR is, and should that person begin CPR on you, Good Sam would protect them from lawsuit. I will check for evidence of a current, valid DNR and if I find one, I'm either going to stop CPR or I'm not even going to start...Cute post. BTW- I am a "DNR", but it's not tattoed on my chest, yet- so think twice about a lawsuit if you get too close to ME. In my view of myself- I coded for a reason, and it's time to 'kiss the sky'~
- 2Mar 30, '13 by wmisaacharrisSo when you become a nurse and say the nightingale pledge, that only pertains to when your at work? I believe A REAL nurse is a nurse at home, a nurse in the car, a nurse at the gym, a nurse at a restaurant, a nurse at a wedding, a nurse in the park, a nurse in bed, a nurse in the swimming pool, a nurse at the mall, etc. If you know how to save them, and yes a nurse is obligated to save them, then save them!! Good Sam will protect you as long as you stay "in your scope of practice". Don't do anything a doctor would do. Do what a Nurse would do.