CPR on a person who is in rigor mortis?

Nurses General Nursing

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One of my patients that I was taking care of was in for ETOH abuse, ascites, and cirrhosis recently passed away. He was living in a assisted living facility where I was working at and based on what I got from report, he came back to the facility the previous night intoxicated. The last time he was seen alive was today at around noon where he asked to take his lunch back to his room. When the health care provider told me to go to the patient's room stat (this was around 7 in the evening), I found him not breathing, on his side, his face swollen. We called 911 and I tried to perform CPR on the patient, but his muscles where stiff and I couldn't separate his arms (it was fixated in a overlapping position). I then attempted to open his mouth, but it was tightly shut. I couldn't even barely get him on his back. The paramedic on the phone told me to keep on doing chest compressions until the paramedics arrive on the scene. I'm still in shock by this incident (I am still a new grad nurse also working at a hospital) and I can't believe that this patient that I've been taking care of for months actually died (this patient had a very friendly and caring attitude to everyone), so yeah, I'm in the dumps right now. Sorry I got sidetracked, but I was researching online on rigor mortis, because I am assuming that this is the condition the patient was in when I arrived to the scene and I just wanted feedback if my actions were valid in this situation?

When we live in a society that someone can sue McDonald's for a burn injury, and WIN, when THEY put hot coffee between their legs, what do you think is down the road for nurses? As a prior wound nurse, I have been deposed several times and come out smiling. My attitude, to err on the side of the patient and always document everything, has always come through. Things change on a day by day basis for nurses. That's why this web site is so wonderful. Remember the old saying: "Never say Never". Since you are getting various opinions on this issue, I recommend that you attend a seminar on Legal Issues. There are several Rn's/Lawyers who give wonderful seminars on this issue and others. A few years back, at least 2 administrators were actually given jail time for acquired decubitus ulcers in their facilities. " Things aren't done like they used to be."

Specializes in ICU, School Nurse, Med/Surg, Psych.

Some states don't allow nurses to pronounce death- you call the provider and say pulseless, no BP, fixed and dilated pupils- same thing as dead. 911 operators are not trained to determine what is wrong with your guy so they are required to tell you to do CPR- some drug overdoses can cause rigor and the person is still alive. Anyway- you didn't hurt him. It's sad and kind of creepy but not the last time by a long shot.

This is just an "in general" statement... to the OP, you're a New Grad and you acted like one. You did the right thing given your experience level. Good job.

Thank you so much for this statement. I'm a new grad and I KNOW I haven't seen anything yet. I'm driving myself crazy with what-ifs before I've even started. This is the first time (that I can remember) I've seen someone congratulate another nurse for behaving like a new nurse! I'm so scared I'll get into a situation where I have no clue, and get chastised for not knowing...anyway, I just had a huge sigh of relief, reading this. I hope my orientation and facility training will help me feel more confident but that's still a few weeks away.

Specializes in Pediatrics.

Teeniebert - I think that most nurses can recall a "New Grad" experience when they first started nursing...(or else they purposefully put it in the back recesses of their mind so that they don't have to relive that particular experience or they are lying). The great thing is that eventually you will be able to laugh at yourself for those fun "new grad" experiences.

As for the original situation...WOW...I am surprised that the HCP just said to check on the patient & then bailed!!! Very supportive...hmmm.

Don't think this is unusual. When I took ACLS we were told about the dose for atropine ona person who's alive and a personwho's already dead. But it still wrenches your heart. I feel alot different about DNR after being a nurse from what I used to.

Specializes in L&D,surgery,med/surg,ER,alzheimers.

It has been awhile so I may be mistaken but a person can be presumed dead if there is an accident causing catastrophic tissue or blood loss or if there are a lack of vital signs causing rigor.

Specializes in Geriatrics.

When we live in a society that someone can sue McDonald's for a burn injury, and WIN, when THEY put hot coffee between their legs, what do you think is down the road for nurses?

Oh please. McDonald's should not have served a cup of coffee that was capable of scalding a person. They were found guilty of having their machines turned up way too high. She had every right to sue and win.

OP, if you were told to perform CPR then you did the right thing. Obviously there was no point but you have to do what you have to do.

Specializes in Trauma, Teaching.

To the OP, you did the right thing, you tried. :heartbeat and hugs.

90-95% of the time CPR doesn't save them, even if you start when they are still pink and warm. But it does work often enough to make it worthwhile; I've seen it go both ways.

As for McDonalds, the place had already been cited multiple times for overheating the coffee and creating dangerous situations. The elderly lady required multiple skin grafts to put her thighs back together.

I refuse to believe that an experienced nurse would perform CPR on a person with rigor mortis. I KNOW we are smarter than that. For the record, rigor mortis is one reason a paramedic can pronounced someone dead on the scene without a doctor immediately present. Also on the list is decapitation. I also REFUSE that anyone would perform CPR on someone who is decapitated! Just blow into the hole where the airway SHOULD connect? (lol)

I was just using the McDonald's coffee thing as an example of how sue happy our society is. You don't need to defend McDonald's to me. I eat there. Sorry if you took it personally.

Specializes in NICU, Post-partum.
Breathe. Relax. You meant well, and that's what counts. Yes, usually one would not start CPR on someone in rigor, but I suppose if the guy was not a DNR and was a full code, then what choice have you got? At least you should probably make an attempt, then be sure to document that muscles were stiff, etc. Your actions were valid. If you have this situation again, you will know what to do.

Rigor mortis, as the previous poster stated, starts 3 to 4 hours after death....consistently. It is so consistent that how much of the body has stiffened is used to "time" the death within a 30-minute block.

You cannot revive someone that is in full rigor mortis...at all. Medically impossible. If the people at the facility had been able to do so...they would need to call the news, because they would have been the first in medical history to do so.

That is why it wasn't necessary.....and it further damages the body that makes a presentation, in an open casket funeral, should the family choose to have one.

Specializes in Rehab, Infection, LTC.

we found a patient dead (LTC patient). he obviously had been dead for a few hours. he was a full code. i didnt start cpr because it was obvious he was very very dead. i called the family, told them and then just called the funeral home after letting the doc on call know.

about a month later we got a letter from the family's attorney. nothing came of it as the man was very dead and i had done some good documentation but our medical director and i were grilled for some time.

from now on..i dont care how dead you are...if you are a full code, i will call ems and initiate cpr, no matter what.

that experience was enuf for me.

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