CPR after rigor mortis

Specialties Geriatric

Published

Hello All, Do u know where I can find information referring to Long term care scope of practice for RN's? What is the policy on starting cpr after rigor mortis set in? Thank you:)

Specializes in Med/Surg, Ortho.

Uhmm, dont think you'll find me in there doing CPR on someone who has rigor set in. They can teach that all they want, doesnt mean its going to be done. Most families would be distraught knowing their family member was being disrespected like that after death.

I doubt if a family was told their person passed away quietly in their sleep they would ask why didnt you do CPR when you found them. As long as documentation was there to the fact that the person had been turned and care given when the patient was last noted alive and that it wasnt an extremely long period of time between that and the patient being found that would be enough for a family to accept.

I would probly question the nurses common sense if i found they DID CPR on a family member of mine after rigor had set in. I would probly be complaining and asking if they were just practicing technique or what.

I agree with you alicia18. Explain to the family exactly what CPR entails and then let them make the decision. I don't believe that families need to think it will always work because we all know that it doesn't but you need to at least try if that is what the families choose and of course if rigor hasn't started. That's just my :twocents:

We teach in CPR courses that you dont have to do CPR if the following exists:

1. DNR Order Present (hard copy)

2. Physician present and pronounces patient

3. Rigormortis is present

4. Severe Trauma

But whats concerning to me is that you would find a patient in rigor mortis...How often do you check your patients? Im guessing this is LTC, but still.....Dont these people have meds, need to be turned, checked for incontinence or so forth?

Also a facility that doesnt do BLS? Run from that facility as your well being is in risk. Your educator needs to review the laws and practices revelant to resuscitiaton and do's and dont's. I could see a charge of abuse or negligence in a case of CPR to a patient with rigor mortis.

Weird Story..........Ive got another one.

We got a stat page from the lab stating a patients potassium was 9.5. yes, Potassium. We started to go into the room and they physician is walking briskly to the room as well (He got a page). We go in there and the patient had expired. The lab tech had drawn blood from a person that just expired. He just walked in there and stuck the guy and left.....didnt realize he was dead.

Correct me if I'm wrong, but doesn't rigor mortis set in 6-12 hours AFTER death? And the passing of it occurs in another 24 or so hours, depending upon the environmental conditions...

Specializes in Cath Lab, OR, CPHN/SN, ER.
Aneroo ~ I work in a faith based community where residents and families are comfortable with death and dying and not doing heroics. We openly discuss these things with our residents and families! Does it really make sense to do CPR in this population?:rolleyes:

If someone absolutely insists, we tell them we will call the EMS. And we do, well before they are ready to code!:)

This has never been a problem.

OK- Yes, it does make sense to do CPR. Anywho, as someone said, we have to agree to disagree. However, on the NC BON website, it has a section for discplinary actions. There are numerous people in NC who have lost their license for failing to start CPR on a full code patient. Be careful! -A

OK- Yes, it does make sense to do CPR. Anywho, as someone said, we have to agree to disagree. However, on the NC BON website, it has a section for discplinary actions. There are numerous people in NC who have lost their license for failing to start CPR on a full code patient. Be careful! -A

That is not an issue here as residents and families find out before admission what our policy is. They are in agreement with it if they come to live here. We cannot be "disciplined" for following our stated and known policy!

If a person wants CPR, its your job to give it to them. If a person wants to be a full code and their 90, then they are a full code. We are here to honor their wishes, leaving our personal beliefs behind. We tend to think whats right for us is whats right for them.........

correct me if i'm wrong, but doesn't rigor mortis set in 6-12 hours after death? and the passing of it occurs in another 24 or so hours, depending upon the environmental conditions...

rigor mortis is the state a body reaches when the oxygen supply to the muscles ceases but the cells continue to respire anaerobically (without oxygen). this causes lactic acid to build up, which affects the muscles causing stiffening - rigor mortis. bodies become stiff after about three hours and remain that way for around 36 hours. rigor mortis ceases as the body cells die, enzymes are released and the cells decompose.

BOB...Did you know that this patient had expired yet??? I mean, even if the lab tech/phlebotomist thought he was asleep or lethargic, it takes time to draw blood and process it. If the patient expires, usually a sheet may be over them or curtain pulled and all lights on...something??? Just trying to understand that story. I have to agree with you on TIME issue....Actually, I have seen rigor mortis show up under one hour, but anyways, it does look bad to find someone cold and blue. But I can sure see how it happens in these LTC. Maybe that is why she wants cpr done, to make some attempt to prove that they actually care for their patients.I have seen the worst care possible and am currently trying to better one of these LTC facilities as a homecare nurse who visits.

Specializes in Pediatrics.
Aneroo ~ I work in a faith based community where residents and families are comfortable with death and dying and not doing heroics. We openly discuss these things with our residents and families! Does it really make sense to do CPR in this population?:rolleyes:
Sounds like a nice place to work, where you get to die with dignity. Does this mean all of your patients are DNRs?

If someone absolutely insists, we tell them we will call the EMS. And we do, well before they are ready to code!:)

That must take impeccable (sp) timing, musn't it? I'm guessing you mean when they start to go bad. As we all know, it can happen at a moments notice. I work with peds, and that is usually the case. We'd have about 10 pts if that rule were in effect at my facility.

It's obviously a very personal and spiritual decision, and i don't think there is a right or wrong. If the pts that are in donmom's facility are anything like some of the kids in my LTC, then you're not really bringing them back to 'life', as there is hardly any quality to begin with. Please don't tell me how crual I sound, but I've seen way too many kids linger and suffer, who have been coded multiple times, because the family is not ready to let them go. I thank God that I am not in their shoes, and hope that I would make the right decision if I were. I just think it's wrong to preserve life at any cost.

Specializes in Critical Care/ICU.

Here's some food for thought and to elaborate kinda what bobnurse is saying.

This is a very personal thing for me but I wanted to share it because it's also very interesting.

My dad, who died in October, had a limited autopsy done the day following his death. The medical examiner reported that while there was lividity (the pooling of blood to dependent areas), there was no "stiffness" (rigor mortis).

That is because rigor mortis is transient. The rigor relaxes after a while.

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