Disregarding 911 dispatcher

[16mm]

An acquaintance of mine witnessed someone having a seizure in a restaurant. She and several others jumped up to assist the woman. 911 was called. The dispatcher informed the group that help was on the way and to wait the seizure out. A woman said the victim was turning blue so they needed to start cpr (no pulse was checked). The dispatcher informed them she was actively seizing and not to touch her.

They started cpr anyway.

This woman eventually ended up dying.

Now, I'm wondering if the inappropriate cpr that was started contributed to this woman's outcome? Could performing cpr on someone with a pulse be fatal?

Should I inform the woman that it's best to wait seizures out since they're generally self limiting. I don't want her to take offense, but I also don't want her thinking cpr is the appropriate response for seizures if she were to ever witness another one in the future.

[remotefuse]

CPR should not be started without a pulse check. She very well may not have needed it at all. Also, restraining someone during a seizure can cause even more injury. The disbatcher was correct. The best thing to do during a seizure is clear any headspace and turn into their side of possible.

[16mm]

That's what I was thinking also. They said when EMS arrived they checked and there was no pulse. But this is after they'd been doing cpr for quite some time. Could that have contributed to it?

[Alex Egan, LPN, EMT-B]

CPR for bystanders and per EMD protocol. Should be started on someone who is not breathing or has irregular respiration.

In the absence of another mitigating factor. Such as a seizure. If someone is reported as seizing and then becomes unresponsive that is expected and will not prompt the dispatcher to immediately initiate CPR instruction.

This is complicated because some cardiac arrests present with some seizure like activity.(very rarely and very briefly)

The woman was most likely in cardiac arrest. She was most likely always in cardiac arrest. The "seizure" was most likely not a true seizure but related to hypoxia.

CPR on a beating heart will not cause trouble beyond the physical injury of the compressions, broken ribs etc. that's why the recommendation is to start CPR without delay. It is also why rechecking of pulses was removed from the AHA BLS training. To many people stopped incorrectly.

[JKL33]

CPR should not be started without a pulse check.

That statement is not in line with current BLS instruction.

The dispatcher only knew what was directly reported, which very likely may have been inaccurate.