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?

I'm not worried about looking like an idiot. I'm only worried about actually being an idiot. I have brought back at least 3 patients, who I didn't think had a chance in hell of being revived. Each one of them, or their family, thanked me for my effort. We MUST err on the side of the patient, not react to how we might look. What is to be lost by doing CPR on a patient who wants it - except a little time? Are we as nurses getting COLD and INSENSITVE? Why take the chance that we MIGHT be wrong? We are not GOD!!!!!!

Are you being serious or is this a joke? God could be running the code, but if a person is in rigor mortis, they aren't coming back! Performing CPR on a person with rigor mortis is p o i n t l e s s. We're talking rigor mortis, people! RIGOR MORTIS!

Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

i still say there is no reason to not perform cpr on a patient who is listed as a full code. why not? does it take too much of our very valuable time? h-m-m-m?

i have too much training in critical care and trauma to perform cpr on someone in rigor. i do not want my colleagues--nurses, physicians, and ancillary staff to think that i should know better.... i know better. i am not new. if you are an experienced nurse, you should know better. let's not do something that will make us look like dingbats.

i can understand a new grad---it's almost reflexive--it's overwhelming and new. but let's not escalate this into, "go for it"..when we know better!!!!!

:banghead:

Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
I'm not worried about looking like an idiot. I'm only worried about actually being an idiot. I have brought back at least 3 patients, who I didn't think had a chance in hell of being revived. Each one of them, or their family, thanked me for my effort. We MUST err on the side of the patient, not react to how we might look. What is to be lost by doing CPR on a patient who wants it - except a little time? Are we as nurses getting COLD and INSENSITVE? Why take the chance that we MIGHT be wrong? We are not GOD!!!!!!

Hello????

Rigor mortis???

Hello?????

:confused::banghead:

I'm not worried about looking like an idiot. I'm only worried about actually being an idiot. I have brought back at least 3 patients, who I didn't think had a chance in hell of being revived. Each one of them, or their family, thanked me for my effort. We MUST err on the side of the patient, not react to how we might look. What is to be lost by doing CPR on a patient who wants it - except a little time? Are we as nurses getting COLD and INSENSITVE? Why take the chance that we MIGHT be wrong? We are not GOD!!!!!!

Unfortunately, with rigor mortis, there is no chance. A person has been dead for so long that calcium has in essence "seeped" into the sacromeres of their muscle cells. That is why rigor mortis is considered a recognizable sign of death. This goes beyond coding somebody who may not have a chance. With rigor mortis, the patient is dead. When we do CPR, we do so because we have a potentially viable clinically dead person. Rigor mortis is just plain dead.

Gila had a good point about lawsuits-ANYONE can sue you over ANYTHING. Because you are named in a lawsuit does not mean you have done anything wrong, it just means you were involved in that pt'.s care. Lawsuits are like a fishing net, they cast over a large area.

I have been involved in 2, both times because the doctor decided to blame the nurse, but because of excellent charting, I was able to clear myself of involvement.

What I found most amazing each time was how little the hospital attorney really KNEW about medical/nursing practice, and how much I had to walk him through the chart.

I would be very disappointed if any nurse would be so silly as to perform CPR on a REALLY dead person because of fear of being sued. I know you have pressures of many kinds, and I cannot blame a new grad for not being so discerning. BUT, this kind of thinking is what causes our judgements to be second guessed during those 3am telephone calls. Because, believe me, that incident made the rounds.

One reason to have is that one does not have to be so terrified of a lawsuit. Knowing you won't likely be ruined financially makes it easier to exercise good nursing judgment rather than playing prevent defense.

Specializes in Agency, ortho, tele, med surg, icu, er.

consider it practice :)

Specializes in NICU, Post-partum.
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.

...and the attorney probably, in all likelihood, wasn't told the full story.

Family probably said: "Our Dad died, he was a full code and the staff did nothing to save him! They even admitted it when we asked!"

Attorney: "I'll file papers immediately...I am so sorry for your loss!"

Facility Administrator's Response: "Did the family mention that we have documentation that he was dead for several hours before he was found?"

I think that is where things ended.

This is where nurses don't have to worry about the obvious...the vast majority of the American public, know full well, thanks to the media, television, health reports, etc...that you 100% cannot revive someone that has been dead for several hours.

The only attorney that would be foolish enough to take a case like that is one that I can assure you, isn't taking the case on contengency because it just ain't winable.

Specializes in NICU, Post-partum.
Why should patients bother to fill out advanced directives and CPR wishes if the nurse in charge can just decide, not to do CPR? I have never seen an advanced directive that specifies: Do CPR unless the nurse in charge of my care decides it's not necessary! We ALL know nurses who's judgement is questionable. This is the last post I am going to make about this, since I think that we are" beating a dead horse." The difference is that the dead horse doesn't have any one to champion his cause. Patient's have family members who may feel differently. I still say there is NO reason to not perform CPR on a patient who is listed as a full code. Why not? Does it take too much of our very valuable time? H-m-m-m?

Because you have obviously, never seen a family member, or tried to have one embalmed that had CPR performed on them after they had been dead for some time.

If you had...and you saw that they didn't look "peaceful and asleep" but instead a horrible, bloated and beyond the skills of the local mortician..and had to have that memory burned into your brain as the last image you ever had of someone.

Trust me, you would think it was a VERY big deal.

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