I Just finished a CPR class and was wondering how often you use CPr as nurses and if anyone has had to use it in an emergency situation outside of the job? CPR used to seem sort of like no big deal, before I took the class, now I feel like if I had to I could actually save someones life with it .
PS .Im a nursing student that hasnt gotten to clinicals yet so this is my first exposure to any kind of technical training.
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.
with no cpr i think my cpr teacher said that every min your survival chance goes down 5% --- i think that is the statistic
I have not yet done CPR on the job as a nurse but many years ago I volunteered with a BLS response unit and an ALS response unit. I have done CPR 7 times in my life and of those 7 patients, 4 were eventually discharged from the hospital. Incidently, it was me and the same EMT-P that worked on those 4 that survived.
CPR does work but CPR alone?? The odds of survival from my experience are clearly extraordanary and not the norm and are way above the average survival rate.
Having called codes (2 as a student nurse), going to many codes and spending many years as a volunteer CPR instructor, I thought I'd put my $.02 in.
Do we sometimes flog the perverbial dead horse? Oh Yeah.
Do we sometimes revive someone who goes on to live a great life? Oh yeah.
Do we sometimes just give a bit of time, allowing family to say goodbye? Oh yeah.
Many years ago I was at a CPR conference where one of the talks was on the miracle of CPR. A little bit later I had a great example of that. My exhubby and I were teaching CPR for a highschool teacher ( phys-ed class Grade 11/12) every semester. I got a call from her "Know what some of my students did on the weekend?" I said no, drugs? (okay, I have a perverted sense of humor) "They did CPR!"
3, 16-17 yr old boys are out somewhere when the Grandma, in the family in front of them, collapses. One ran for the phone to call 911, one started CPR, the other looked after the family.
Grandma stayed dead. By Monday, the family had contacted the boys school, and the newspaper and written all 3 boys letters of thanks (the police had attended the scene and they got the info from them). The boy who ran for the phone hadn't been in her class yet but was going around the school saying everyone should try to get her as a teacher so they could learn CPR!
So 3 teenagers made a decision that they would be good citizens in society and help others. That's the miracle of bystander CPR.
I've seen people make a full recovery. I was just pointing out that that is the exception, not the rule.
One of the Laws of ICU: Asystole is a very stable rhythm. (I think I'll post all the Laws later tonight.)
I wasn't saying people shouldn't bother - of course they should. If there is even a small chance . . . it's a chance worth having.
I was speaking to the OP as an up and coming healthcare provider, not as a lay person. As a lay person, CPR has a different connotation than it does to somebody that is going to perform it many times during a career.
Bottom line, the human body has the amazing ability to compensate - until it can't. And at that point, CPR absent ACLS (adv card life support - drugs/electricity/ambu/etc) is more likely than not to be spit in the wind. (ex - outside of the hospital, most people collapse and die due to SCA - Sudden Cardiac Arrest - most likely due to a clot or other total or subtotal occlusion of the Left Main heart artery. CPR simply isn't going to open up that clot - OR - provide that heart muscle w/ oxygen (and so, it is not likely to change the outcome). Now electricity (defib) might convince that heart to keep trying for a few more minutes - until MONA arrives. (Morphine, Oxygen, Nitro, Aspirin) Those things can open the Left Main just enough to get to the Cath Lab (or at least get oxygen around the clot/occlusion by providing more oxygen, making the artery larger by comparison to the clot/occlusion and, in the case of Aspirin, by tapping the brakes on the fibrin cascade the makes and sustains a clot).
But that doesn't mean I wouldn't recommend CPR, if the alternative was, as somebody said, to stand over that person and go 'tsk, tsk'.
I've done CPR twice, participated in many codes though- just wasn't thumping a chest.
I've seen the ones where the call it a minute after the patient rolls in the door (the 95yo 90lb nsg home pt who should have been a DNR several years before), and the ones where they code them for God knows how long because it breaks your heart to see someone young die.
If you're worried about what to do in nursing school clinicals, don't. If your patient codes
1- You KNOW what to do. ABC. Scream for help, hit a code button/staff assist, and start bagging/thumping. When the code team arrives, jump outta the way and watch!
2- Hopefully someone would have caught on that something 'wasn't right' about that patient and that they were circling the drain prior to your patient coding.
Specializes in med/surg, telemetry, IV therapy, mgmt.
I understand that those of us who are seasoned like to discuss the value of doing CPR and how many actually survive it. However, I think that it is important that those who are new to nursing understand that in a code situation we nurses don't sit around discussing whether doing CPR on patients is worth the trouble or whether the patient is going to survive it. Bottom line is that you carry out code blue procedure--period--unless the patient is a DNR. We discuss the merits of it in the break room.
I've seen the CCU nurses do a lot of code blues where patients do survive and go on to walk out of the hospital.
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.
I wasn't going to bring this up unless someone else did. First time I ever did CPR was on a 10 y/o kid w/CP. I wasn't even a nurse, just started nursing school. The kid threw up in my mouth. GAHHHHHHH Well, at least it was a kid. Couldn't wait to get to some mouthwash.
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.
I don't have any cold hard facts to back me on this one but sometimes I admit, I wonder if the reason CPR is ineffective is because people aren't doing it right.
If you were a NON-med professional and you were at the mall and some little old lady keels over with an MI, are you likely to really push and do the compression correctly especially considering it is likely the first time you have ever done this procedure on a real live person vs. fake chest? Or if you feel a rib crack are you going to believe you are doing it too hard? And there is NOOOO mistaking cracking a rib, you know what you just felt.
On one hand I wonder if people do it too hard due to the anxiety of the situation, OTOH, I question if people actually do it hard enough.
I've felt that rib crack before and I kept on keeping on. But do you really think someone in a mall who is not an EMT, paramedic, LPN, RN, MD/DO is going to push hard enough? Especially on an older type person? And who needs it most often? Older folks. I don't know, just something I have considered before.
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.
I didn't realize it was that low, I guess I thought it was a bit higher. What about the type of breaths? It isn't a normal type breath, it is a deep breath pushed out quickly. Wouldn't that make a difference?
They've actually changed the ratio for CPR for adults. I belive it's now 30compressions: 2 breaths.
I *think* one of the reasons behind the change was because of the lay person being reluctant to do rescue breaths.
Remember a football game where a lady coded in the stands. God Bless her, she coded in the right spot- she was surrounded by doctors and nurses (although they were a bit tipsy). We were with her in less than 2 minutes, all the while she's had CPR. A bystander did rescue breaths, she was defib'd in the first few minutes, and was speaking by the time they were taking her to the hospital. The bystander was totally freaked out though- "OMG, what if she had some disease. Who do I call to make sure I'm ok?".
They've actually changed the ratio for CPR for adults. I belive it's now 30compressions: 2 breaths.
I *think* one of the reasons behind the change was because of the lay person being reluctant to do rescue breaths.
What good would 30 compressions do with two low O2 breaths? A comes before B and all that good stuff..... Seriously, that's a HUGE difference between the way I've always been taught.
lpnstudentin2010, LPN
1,318 Posts
with no cpr i think my cpr teacher said that every min your survival chance goes down 5% --- i think that is the statistic