Have you ever had to use CPr on the job or anywhere else?

Katnip, RN · Jan 11, 2006

I've worked in IMCU-a step-down and in emergency. We used it all the time.

A few times a week at least we'd get codes called on the other floors, so yes you will use it. We actually went to a code on a med surg floor and the nurses and techs were standing there. No CPR initiated. PT was resused10 times throughout the day in ICU but the pt didn't make it. You better believe those nurses, incliuding the charge, who didn't start CPR were in very hot water. This was originally a stable patient recovering from an uncomplicated surgery.

99_99africa · Jan 11, 2006

Yes I have used CRP on my own husband and He lived can u believe that!

In south africa our Er is like a war zone and used CRP often, enjoy the knowledge and keep up to date.

ZASHAGALKA, RN · Jan 11, 2006

The thing about CPR is that it is 85% ineffective.

By the time you are at the point of dying, not much can really be done outside a hospital - full of nice meds and electricity, ambu bags, and ventilators.

Now electricity stands a much better chance than CPR - and that is why automated defibs are being made as common as fire extinguishers.

Think about it this way: dying is a much more stable phenomenom than living. In the history of the world, there are simply more dead people than living ones.

CPR is intended as a last ditch effort. But it's important to note the 'last ditch' part of it.

Even full Advance Cardiac Life Support in a hospital setting fails more often than not.

If it can save A life, is it important? Yes! But it's also worth placing it in the proper perspective - by that point, it normally won't (kids are an exception to this - mainly because kids normally die as a result of a non-health related 'event' and if that 'event' can be reversed, be it electrocution or drug ingestion, etc, then kids are much more likely to have a better outcome.)

I have used CPR outside the hospital, on my dad. But he blew a bypass graft and nothing outside a hospital would have saved him, and even if he HAD been in a hospital: it probably would have been equally futile.

~faith,

Timothy.

elkpark · Jan 11, 2006

The thing about CPR is that it is 85% ineffective.
By the time you are at the point of dying, not much can really be done outside a hospital - full of nice meds and electricity, ambu bags, and ventilators.
Now electricity stands a much better chance than CPR - and that is why automated defibs are being made as common as fire extinguishers.
Think about it this way: dying is a much more stable phenomenom than living. In the history of the world, there are simply more dead people than living ones.
CPR is intended as a last ditch effort. But it's important to note the 'last ditch' part of it.
Even full Advance Cardiac Life Support in a hospital setting fails more often than not.
If it can save A life, is it important? Yes! But it's also worth placing it in the proper perspective - by that point, it normally won't (kids are an exception to this - mainly because kids normally die as a result of a non-health related 'event' and if that 'event' can be reversed, be it electrocution or drug ingestion, etc, then kids are much more likely to have a better outcome.)

I know it's not a "politically correct" viewpoint in healthcare, but I agree with Z. Even done perfectly, under ideal conditions (and how often is that the case?), CPR (by itself) is only marginally better than just standing over the person and saying "tsk, tsk." My father, a (now retired) anesthesiologist, always said that the only purpose CPR served was to give the floor staff something to do to feel useful while they were waiting for the code team to arrive ... :chuckle And he considered the idea of anyone doing CPR on anyone outside of an actual hospital (or the presence of EMTs prepared to seriously code someone) ludicrous and a complete waste of time.

Even full codes are not the life-saving miracles the general public believes them to be -- and very few people "come back" as good as when they "left" ... I remember that the VA did a huge study a number of years ago, involving several of their larger medical centers around the country, of code outcomes within their system (I heard about it because I was working for the VA at the time), and the results were that not that many folks were successfully resuscitated, and, or those few that were, the vast majority never left the hospital -- they just lived a little while longer and then died again.

I've seen 'way too much over the years. Forget DNR orders -- if it were up to me, "no code" would be the default status and nobody would get coded unless there were a darned good reason to do so (as Z. notes, kids or young, healthy adults who had some sort of freak accident/event that stopped their hearts). Most of the codes are done on people who are going to die regardless of what we do; God is calling 'em home, and we're just prolonging the inevitable (at huge expense and effort ...)

I know everyone gets all excited about saving lives the first time they take a CPR class (and I'm not criticizing anyone for that! It's sweet, really ... :) ), but, as Z. notes, it's important to keep it in perspective.

jmgrn65, RN · Jan 11, 2006

I have know CPR to be a life saver outside of the hospital, I know of a patient that his wife did only compressions and yes he was in VT, he survived, it was a long road in the hospital but he is now living a healthy life. To say it should not be done outside the hospital or it only gives something for the staff to do is LUDICROUS. It does work, depending on the reason, to say that it doesn't is just plain ignorant. There is evidence to prove it works. some people are just limited in their practice and only know what they witness.

Katnip, RN · Jan 11, 2006

It may be 85% ineffective, but that means 15% of the time it works. How many of those will walk out of the hospital? I don't know. But I do know if even one does, then it's not a waste of time.

Yes, electricity is the best shot anyone has, but until the electricity gets to them it can help with perfusion.

amy3072 · Jan 11, 2006

Wow. Ok, I feel useless again, lol. :rolleyes: But I still feel better knowing CPR than not Knowing. Thank you all for your posts.

Daytonite, BSN, RN · Jan 11, 2006

On the stepdown unit I worked, we probably had at least one code every couple of months on my shift during the times I was working. When I was a hospital supervisor we probably had a code every night somewhere in the hospital.

What's it like? The first time I did chest compressions on an elderly person I could feel a rib crack! And my hand placement was absolutely correct. The elderly patients tend to get cracked ribs easily during CPR. The hardest part is maintaining CPR. The first minute or two is OK, but if you end up going at it for 10 minutes or so, you get SOB, sweaty and very fatigued. Someone has to relieve you. You are going to have sore muscles for a week yourself. The hardest are probably the big, overweight people. It seems to take a lot more effort to get their chest compressions adequate.

In the days before the nice little mouth protectors we now have, I used to carry a couple of sterile 4 x 4's in my pocket and put them over someone's mouth before giving rescue breathing. The stench of pulmonary fluid or vomit is enough to make you want to gag and throw up yourself. It took me one or two times of that before I learned to cope. Most people want to go for the chest compressions. Someone has to do the rescue breathing part or the compressions make no difference. I've been at bedsides where someone coded and people stood there for a couple of seconds trying to figure out who was going to do the breathing part--no one wants it. Now, if you've got an ambu bag at hand, I'd go for the breathing. That is so much easier that the physicalness of doing compressions.

ckh23, BSN, RN · Jan 11, 2006

The thing about CPR is that it is 85% ineffective.
By the time you are at the point of dying, not much can really be done outside a hospital - full of nice meds and electricity, ambu bags, and ventilators.
Now electricity stands a much better chance than CPR - and that is why automated defibs are being made as common as fire extinguishers.
Think about it this way: dying is a much more stable phenomenom than living. In the history of the world, there are simply more dead people than living ones.
CPR is intended as a last ditch effort. But it's important to note the 'last ditch' part of it.
Even full Advance Cardiac Life Support in a hospital setting fails more often than not.
If it can save A life, is it important? Yes! But it's also worth placing it in the proper perspective - by that point, it normally won't (kids are an exception to this - mainly because kids normally die as a result of a non-health related 'event' and if that 'event' can be reversed, be it electrocution or drug ingestion, etc, then kids are much more likely to have a better outcome.)
I have used CPR outside the hospital, on my dad. But he blew a bypass graft and nothing outside a hospital would have saved him, and even if he HAD been in a hospital: it probably would have been equally futile.
~faith,
Timothy.

I agree. As a matter of fact I had a discussion about this with a doctor in our ER. Turns out that less than 10% of those revived walk out of the hospital. Unless your coding in a hospital and you are realatively young and healthy then you may have a shot. I think the common misconception is the stories you hear in the news about someone doing CPR and "saving" the persons life. What you don't hear is any follow up on how the patient does in the hospital after the fact. You also never hear in the news about people performing CPR and the person dies at the sceen regardless. When using CPR in a code in the hospital, you are just trying to move enough oxygen to the brain for the few seconds it takes for the difib to charge (except if the patient is asystole). I'm glad someone brought this up, because it really makes you think regardless of what your stance is on this discussion.

RN4NICU, LPN, LVN · Jan 11, 2006

I'm not convinced that mouth-to-mouth rescue breaths really do all that much good. An exhaled breath is only about 17% oxygen. The person's sats are going to fall with them or without them. You are NOT keeping the person oxygenated. However, with compressions, you are getting some blood to the brain and to the myocardium - not much, but in some cases, enough.

pricklypear · Jan 11, 2006

Wow. Ok, I feel useless again, lol. But I still feel better knowing CPR than not Knowing. Thank you all for your posts.

Don't feel useless. Have an open mind, and remember that there ARE people who were saved and go on to live normal lives because someone knew how to properly perform CPR. It's nothing more that a maintenence mechanism, used to try to keep vital organs perfused with oxygenated blood until whatever is wrong can be fixed. It doesn't save the person on it's own, but it improves their chances of making it IF the problem is a fixable one. I've had the pleasure of taking care of several people (usually relatively young who had some sort of sudden cardiac event) who recovered completely after going down outside the hospital in the presence of someone who knew CPR. It works when it's done right, and the problem is fixable.