Studies: Doctors, nurses fall short on CPR

  1. medical personnel often don't follow several guidelines

    chicago - cpr is often performed inadequately by doctors, paramedics and nurses, according to two studies of resuscitation efforts during cardiac arrest.

    whether a stricken patient is in the hospital or on the way, the guidelines for administering cardiopulmonary resuscitation frequently are not followed.

    among common problems: rescuers did not push hard enough or often enough on the victim's chest to restart the heart, and breathed air into the lungs too often - either mouth-to-mouth or through breathing tubes.

    both studies used an experimental monitor that assesses cpr quality, and both received funding from laerdal medical corp., a norwegian company that helped developed the device.

    the studies appear in today's journal of the american medical association.

    more: http://www.lsj.com/apps/pbcs.dll/art...0352/1001/news

    added:
    Last edit by brian on Jan 20, '05 : Reason: added link to JAMA Abstract
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    About Brian, ADN

    Joined: Mar '98; Posts: 15,431; Likes: 16,404
    allnurses.com founder; from US
    Specialty: 18+ year(s) of experience in CCU, Geriatrics, Critical Care, Tele

    11 Comments

  3. by   medsurgnurse
    Quote from brian
    Medical personnel often don't follow several guidelines

    CHICAGO - CPR is often performed inadequately by doctors, paramedics and nurses, according to two studies of resuscitation efforts during cardiac arrest.

    Whether a stricken patient is in the hospital or on the way, the guidelines for administering cardiopulmonary resuscitation frequently are not followed.

    Among common problems: Rescuers did not push hard enough or often enough on the victim's chest to restart the heart, and breathed air into the lungs too often - either mouth-to-mouth or through breathing tubes.

    Both studies used an experimental monitor that assesses CPR quality, and both received funding from Laerdal Medical Corp., a Norwegian company that helped developed the device.

    The studies appear in today's Journal of the American Medical Association.

    more: http://www.lsj.com/apps/pbcs.dll/art...0352/1001/news
    I can hear the lawyers panting over this.
  4. by   RNCENCCRNNREMTP
    Quote from brian
    Medical personnel often don't follow several guidelines

    CHICAGO - CPR is often performed inadequately by doctors, paramedics and nurses, according to two studies of resuscitation efforts during cardiac arrest.

    Whether a stricken patient is in the hospital or on the way, the guidelines for administering cardiopulmonary resuscitation frequently are not followed.

    Among common problems: Rescuers did not push hard enough or often enough on the victim's chest to restart the heart, and breathed air into the lungs too often - either mouth-to-mouth or through breathing tubes.

    Both studies used an experimental monitor that assesses CPR quality, and both received funding from Laerdal Medical Corp., a Norwegian company that helped developed the device.

    The studies appear in today's Journal of the American Medical Association.

    more: http://www.lsj.com/apps/pbcs.dll/art...0352/1001/news
    CPR does NOT "restart the heart" as quoted in this article. CPR tries to maintain some degree of cardio-cerebral perfusion until advanced treatment (defibrillation and drug therapy, but mainly defibrillation) can be brought to the patient. CPR was not meant to be used on everybody but for those suffering sudden cardiac arrhythmic death as a stop-gap until ALS.

    Stop saying CPR restarts a heart, it does not!!!!!!
  5. by   cjkes78
    This article really irritated me. I am a nursing student and I just got my AHA BLS for Healthcare Providers. I think it is difficult to get all 100 compressions in a minute. CPR is very tiring ... I know my class was wore out just practicing on the mannequin. When will people realize that health care providers are only human and do the best they can?
  6. by   macspuds
    :imbarIt is sad that things like this happen, but I sincerely feel that anyone who decides to get "envolved" in attempting to help by administering CPR would do their best to do so correctly.
    I guess my question is How does someone monitor the correctness of CPR on a person when they should be too busy helping the person who needs it?
    One cannot place monitors on each person who is getting CPR to measure correctness can they.
    I would think that anyone who initiates CPR on a person would know how to do it or they wouldn't do it at all.
  7. by   elkpark
    These articles show up every few years. The one thing that everyone overlooks when they get all self-righteous about the "correct" way to do CPR is that CPR, even done perfectly, is only marginally better than doing NOTHING AT ALL. My father, an anesthesiologist, has always joked that the only thing CPR accomplishes is to allow the floor staff to feel they're doing something useful while waiting for the code team to arrive ...
  8. by   Brian
    i just updated the original post with a link to the jama abstract, here it is as well:

    link to abstract from jama:
    http://jama.ama-assn.org/cgi/content...urnalcode=jama
    Last edit by brian on Jan 20, '05
  9. by   Brian
    Here is a related article, except this is Out-of-Hospital Cardiac Arrest :

    Quality of Cardiopulmonary Resuscitation During Out-of-Hospital Cardiac Arrest
    http://jama.ama-assn.org/cgi/content/full/293/3/299
  10. by   macspuds
    :stone
    Quote from elkpark
    These articles show up every few years. The one thing that everyone overlooks when they get all self-righteous about the "correct" way to do CPR is that CPR, even done perfectly, is only marginally better than doing NOTHING AT ALL. My father, an anesthesiologist, has always joked that the only thing CPR accomplishes is to allow the floor staff to feel they're doing something useful while waiting for the code team to arrive ...
    Thanks for the nice reply.
    macspuds
  11. by   Brian
    I don't take offense to these studies? Yes, these articles may come out every few years, and yes, maybe CPR isn't much better than doing anything at all.... but, if people can improve their technique, and possible provide a better compressions etc... through some studies that might evoke better education or more effective treatments, devices etc... just my

    If we didn't study things like this or any other practices, we wouldn't have reason to ever improve anything? Research is not always our enemy.
    Last edit by brian on Jan 24, '05
  12. by   JBudd
    ""I guess my question is How does someone monitor the correctness of CPR on a person when they should be too busy helping the person who needs it?""

    #1 Observation: as an instructor I am supposed to watch my students to see if they are reaching a good depth: so I'm used to watching others during real CPR situations. People don't always get deep enough. Also, I watched one nurse literally bouncing her hands of the pt's chest, going back down at random spots.

    #2 By palpating femoral pulses during CPR and when you stop to see if anything is now showing on the monitor (after giving drugs etc.). I've been told I give powerful pulses while pumping, and they disappear during pauses.

    #3 Color: At an accident scene, one body was turning purple (CPR not an option), while we worked on the one next to him. The CPR pt stayed noticably pinker, although he didn't make it. Took the helicopters an hour to find us in the mountains. Yes, we kept it up that long, it can be done. In the 80's the rule was "don't stop".
  13. by   UM Review RN
    The new Zoll defibrillator has CPR recognition and correction capability and a number of other sweet features.

    http://www.zoll.com/AEDPlus-lo-fixed.pdf

    Take a look at the brochure. Better yet, there's an actual demo video on the www.zoll.com website for the AED Plus.

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