My TCU CPR policy

[unsaint77]

Even for full code pts, my TCU CPR policy is not to do CPR if the pt is determined to be dead. The TCU protocol qualification for being dead is no pulse and no response to stimulus. (a person without pulse will not respond to stimulus so it's essentially saying no pulse means dead)

Is this common?

[cro7690]

I guess I do not see the point of such a policy. The whole point of CPR is to keep the blood pumping to the vital organs, hoping it the heart will restart. I have never heard of such a policy. If this is truly the practice I would look elsewhere for employment because I would think your license could be in jepardy I know it would be in Ohio.

[psu_213, BSN, RN]

And what do you mean by "clarify?" I typed the policy word for word.

I believe that I am thinking the same thing as the person who asked you to clarify--sorry if I am putting words in someone's mouth. The policy, as written, appears to me mean no CPR ever. Before you stand there and not do CPR on a witnessed arrest, I think clarifying the policy is good idea.

In addition, I think "the point of no return" does need to be better defined, because not having a clear policy on when to intiate CPR and when not to intiate is going to create problems if someone chooses not to intiate just because that RN felt it was a futile effort.

[LaughingRN]

I am uncomfortable with this.....that policy essentially says let everyone die. PM me their name and I'll report them. At least there will be an investigation to find out this is true and understood properly. This is a TCU not a hospice unit.....I'd go to the media now. This policy is a problem.

NO AEDs? Wow this place needs to be closed down. go to the joint commision web site and file a complaint. Here is the link. The will investigate. Call the state.

http://www.jointcommission.org/report_a_complaint.aspx

Thanks for saying this.

I fully support you passing on the information to Esme12 so she can report this.

Absolutely disturbing

[Enthused RN, BSN, RN]

... as determined by a licensed professional.

Maybe they define licensed professional as a MD or paramedic? Those are really the only 2 who can legally declare someone dead, right? As a previous poster said, I would clarify with your facility on what exactly they mean and talk through some scenarios with them. For me, I would start CPR until a MD or paramedic gave the declaration.

[Epic_RN]

Having just gotten my ACLS certification, this greatly disturbs me. Per ACLS guidelines, you do not attempt compressions only if there is a DNR or rigor mortis present. In my facility, we attempt resuscitation regardless of rigor mortis being present unless there is a DNR.

[LaRN]

woops

lmao

[tothepointeLVN, LVN]

I would have to believe that policy refers to someone that is not only merely dead but really most sincerely dead. When someone is most sincerely dead you know it.

[PetsToPeople]

"Obviously dead" needs to be defined? How can you tell the difference between 3 minutes and 30 minutes dead?

I agree, if "obviously dead" was added to a policy, it would have to be defined, otherwise you would be opening yourself up to major liability because the facility would be able to pass the buck onto the nurse.

[PetsToPeople]

Obvious signs of death include dependent lividity aka livor mortis (20min-3hrs), rigor mortis (1-3 hrs post death)...anyone think of other examples? Possibly obviously low temperature that is felt by hand but that may be too subjective...

[sckitty]

Props to the commenter that said she would report the facility!

[sckitty]

"Clarify" means you go up to the DON or administrator and say, " I have read the policy on this over and over. It seems to me ...(liability, DNR, responsibility,blah, blah) Can you CLARIFY this for me?"

[wooh, BSN, RN]

I think "obviously dead" is what the policy was trying to say, giving things like no pulse. Unfortunately, the criteria listed, such as no pulse, are the criteria for DOING CPR. I think the policy was probably written with good intent, just badly done.