questions about doing CPR

[ajaxgirl]

Where I work, if someone is a full code (nsg home) we do CPR only if the cardiac arrest is witnessed.

YOu wouldnt do CPR if they were found dead in bed.

Is your policy the same?

[tvccrn, ASN, RN]

Having worked in LTC/Prison/ICU/ER and I can tell you that it does make a difference. You need to able to defend your actions based on objective assessment findings and get the provider on the phone ASAP to back you up, but there are reasons for this policy and I am sure many LTC facilities have done it this way for years w/o legal difficulties.

By the way tvccrn...What does your screen name mean? I am just curious I got my LVN from community college named TVCC.

What actions would you need to defend. If you start the code when you find someone down, you are doing what the patient wants. If you don't because whatever reason, then I can see needing to defend your actions.

The tvcc is from Trinity Valley Community College in Athens, Texas. Is that where you graduated from?

tvccrn

[NicoleRN07, RN]

It shouldn't matter whether is was a witnessed arrest, a full code is a full code. I work in the ER, and have responded to codes on the floor where the patient has been dead for a while, and we work them, usually one round of drugs, and the doc calls it.

[wtbcrna, MSN, DNP, CRNA]

It shouldn't matter whether is was a witnessed arrest, a full code is a full code. I work in the ER, and have responded to codes on the floor where the patient has been dead for a while, and we work them, usually one round of drugs, and the doc calls it.

Yes, but have you ever worked in LTC where it was the normal to have some very independent patients that could have been dead for 7+ hours because it was the night shift and these particular patients don't get checked every two hours. I have seen what you are advocating doing in the prison where someone is dead for several hours....No doctor is there of course.....The patient is brought into the medical bay and everyone plays at doing chest compressions/ventilations until they can clear it with the provider on call to stop.

Again, I don't think someone can really understand the difference until you have worked in both LTC and the hospital settings. I would do just like you in the hospital but that is the hospital with the resonable expectation that these patients are checked every 2-4 hrs bare minimum.

Also, keep in mind as the nurse in LTC it is your decision to make if you don't feel comfortable not starting CPR on patient that has been dead for several hours...start CPR...call 911...and let the paramedic (on the advice of the medical director) call it. Just because the policy gives you that option doesn't mean you have to follow it.

[ginger58, ASN, RN]

No, everyone is coded, even if cold and stiff. (I work in a hospital.)

It seems to me that if you fail to do CPR on a pt without a pulse then you are declaring death, which your nurse practice act probably does not allow you to do.

In the state of California 2 nurses are allowed to declare death. I would feel really stupid doing CPR on someone without a pulse, respirations, cold and stiff and dilated pupils.

[nurseofalltrades]

I also work in LTC/nursing home. If a resident is a full code we must administer CPR whether cardiac arrest has been witnessed or not. Most instances if res has been gone for any length of time the RN in charge can cease CPR when he/she sees fit.(can call time of death sooner if res cold and stiff hten if still warm and having a chance!)