First CPR/Arrest - not in hospital....

[Michelle123]

I was visiting friends of the family yesterday and the woman who was in her late 70's with health complications stopped breathing.

We rang the ambulance and I commenced CPR.

It is the first time for me on a real person.

I felt her rib break - which I knew would happen, but there is a difference between knowing something theoretically and experiencing it, and the gurgling noise, no one tells you about that....

When the paramedics arrived, they were eventually able to get her heart beating again, but she wasn't breathing on her own.

She was taken to hospital where her heart stopped again and she was unable to be revived.

I never thought my first time with CPR would be without any experienced nurses to lead me. I never thought it would be out of the hospital and I never thought it would be on someone I knew well.

The paramedics told me that I had done it well and they wouldn't have been able to get her heart started again if the CPR hadn't been done properly.

The thing is, I am not convinved that I did the right thing.

I don't know what her wishes were. Her family knew that she wasn't goning to be around much longer. The whole time I was giving the compressions, I was thinking this is so cruel....

Has anyone else experienced this before?

[NotReady4PrimeTime, RN]

You did the right thing. You did a good job. Even if she had no desire to be resuscitated, the reality is that survival from out-of-hospital arrest, no matter whether they receive early effective CPR, early defibrillation and early advanced life support, is unlikely. Her family knows that your efforts were out of caring and respect and they have the comfort of knowing that this lady was given every chance to survive; it was just not to be.

Now that you have experienced your first emergency and reacted in a cool and professional manner, you'll be much more... umm I don't know if comfortable is the word, but maybe functional?... the next time, when you have backup and equipment. YOU DID A GOOD THING.

[Blueorchid, ASN, RN]

You are absolutely right that nobody mentions the gurgling. Or the inevitable vomiting that happens afterwards, and then of course there's the sensation of ribs popping instead of that lovely little clicking noise you get on mannequins when you're taking CPR classes that instructs you that you're doing it right.

CPR classes are handy- but they're just another example that what we learn in nursing school isn't always what happens in the real world.

In my opinion you absolutely did the right thing. There is always a possibility that when a loved one's health is failing, they'll come to a decision that if that person codes they won't try and revive them again. However I know from my EMT-B classes, unless that person has an explicit DNR that's legible, legal, and carried on them (most people don't do this one...including those that are bedridden and on hospice) you were exactly right to do what you did.

Admittedly I have not experienced this out in the field, but several of my friends have, they happen to be firefighters who went through their EMT rounds in an area where they're kept pretty busy sometimes. Its not an easy thing to go through and the experience has obviously meant something different to each of them, but in the end I think by doing so you become a better provider (in our case nurse) because of it. You know that CPR doesn't exactly look like something straight out of a medical drama and you'll know how to handle it next time.

Its shocking right now but it does become easier as time passes they all agree- there's a reason why a lot of EMS have this really morbid sense of humor as well.

An old paramedic used to tell me before I started nursing school that in doing CPR you have to roll the dice a couple of times before you win the lottery. He also mentioned that the people that you do save make the effort worth it.

[truern]

You did the best anyone could do in those circumstances...actually any circumstances.

Look at the statistics of revival after an arrest. They're abysmal