Patient Conscious During CPR

[Emergent]

Amazing story told to me by an ER doc I work with. A patient he had, a fellow in his 30s, went into V-fib. Due to excellent CPR the patient was conscious throughout the code, which lasted almost 2 hours. They tried everything but could not bring back a rhythm.

He finally had to tell the man there was nothing else he could do, the guy gave a little nod and they let him go. He said it was the hardest thing he's had to do.

[calivianya, BSN, RN]

This is so random, but....

What happens after you do CPR and you're totally toast for the rest of your shift because you're wicked out of shape? That's gotta suck.

This story just makes me really sad, but it certainly seems plausible even if it's horrifying.

I'm super out of shape, but CPR only makes me totally toast for about half an hour. Rest, hydrate, and you'll feel better pretty quick!

(Granted, I usually only end up doing a couple minutes of compressions at a time...)

[nutella, MSN, RN]

You've performed a precordial thump? Fascinating. I've always wanted to witness that.

LOL - as a nurse in cardiac surgery ICU we did that all the time - it only works (if it does at all) though if you do it right away when the patient goes into v-tach. Basically you have to stand next to the bed, see it happen on the monitor and spring into action. I have used it successfully but after that you still need to investigate what is going on because if you do not treat the underlying problem it may happen again...

[meanmaryjean, DNP, RN]

This is so random, but....

What happens after you do CPR and you're totally toast for the rest of your shift because you're wicked out of shape? That's gotta suck.

This story just makes me really sad, but it certainly seems plausible even if it's horrifying.

This really shouldn't happen. I'm over 60 and overweight. I've also taught CPR since 1977. The secret is to always keep your shoulders directly above your hands, and let your body weight do the work. I can do compressions for quite a while before needing relief. Most people make the mistake of having their HEAD above their hands (so they can 'see what they're doing'). Your head should be looking at the surface on the other side of the patient and your shoulders above your hands for maximum efficiency. It's physics kids- visualize a piston!

[NotAllWhoWandeRN, ASN, RN]

This really shouldn't happen. I'm over 60 and overweight. I've also taught CPR since 1977. The secret is to always keep your shoulders directly above your hands, and let your body weight do the work. I can do compressions for quite a while before needing relief. Most people make the mistake of having their HEAD above their hands (so they can 'see what they're doing'). Your head should be looking at the surface on the other side of the patient and your shoulders above your hands for maximum efficiency. It's physics kids- visualize a piston!

I protest at every BLS and ACLS class that they have the dummies on a table that is hip height. I'm just shy of 5'2" and it is Very Bad body mechanics to make someone lean forward on an elevated surface and push down vigorously and repeatedly. People did things right during the real codes I was involved in.

[Here.I.Stand, BSN, RN]

I am going to weigh in on the highly doubtful side.

Assuming one can survive 2 hours of CPR, there would be some documented cases of survival to discharge after 2 hours of compressions.

But, the part of the story where the guy gives a little nod is a great touch, and some say never let the truth get in the way of a good story. I say let the story stand.

We've locally had someone survive and walk out of the hospital after 2+ hours of compressions with the LUCAS. Guy who taught my last ACLS class told us they continued so long due to another local case where an arrest victim survived >1 hr on the LUCAS. Again with good outcome -- he returned to work on a job that requires lightning quick cognitive ability.

Also one of my nursing instructors told a story of a code she was personally involved in, where the woman was conscious. My instructor was in tears telling this story, bc the woman was a young single mother, and she looked at the staff with a facial expression "pleading with us to save her" during the code. I probably wouldn't have believed it if I had just read the story online or something, but all of my program instructors were top notch -- in their skills as teachers, bedside nurses, and in their integrity.

[idialyze, BSN, RN]

30 years at the bedside, glad I missed that! .. thankfully that is not in my current repertoire of nightmares. Closest I came was a patient in v-tach.. gave him a thump and got thumped back.

Me too! Perfect Vtach on the monitor, one good thump, and he was back! He said a few choice words, but didn't try to hit back. Old school treatments Do work!

[roser13, ASN, RN]

I once thought about getting a "DNR" tattoo on my sternum.

I've always wanted to do that. However I learned (here, as a matter of fact) that it was not remotely considered to be binding.

HOWEVER, I subsequently learned (again, on AN.com) that while it is not a legal document, responders will work harder to find a legal DNR once they've seen that tattoo on someone's chest.

[chare]

That's a very nice medical urban legend.

http://www.resuscitationjournal.com/article/S0300-9572(14)00801-6/pdf

[chare]

Duplicate post, deleted.

[canoehead, BSN, RN]

I have also seen a patient become conscious during compressions, and unconscious when we stopped. He looked towards voices, but I'm sure wasn't mentating at near a normal level. We tried extra hard for that guy, but his heart was jello.

[Glycerine82, LPN]

This really shouldn't happen. I'm over 60 and overweight. I've also taught CPR since 1977. The secret is to always keep your shoulders directly above your hands, and let your body weight do the work. I can do compressions for quite a while before needing relief. Most people make the mistake of having their HEAD above their hands (so they can 'see what they're doing'). Your head should be looking at the surface on the other side of the patient and your shoulders above your hands for maximum efficiency. It's physics kids- visualize a piston!

Ahhhh, good to know. :) I just remember doing it in lab on the darn simulation dummy and I was pooped for a good 10 minutes, and it was plastic. Granted, I think we did it about 10 times.

This is one of the many things about actually working as a nurse that scares the complete crap out of me. I'm so afraid I won't remember what to do, or that I'll freeze.

[Been there,done that, ASN, RN]

This is so random, but....

What happens after you do CPR and you're totally toast for the rest of your shift because you're wicked out of shape? That's gotta suck.

This story just makes me really sad, but it certainly seems plausible even if it's horrifying.

Professionals are not allowed to turn into toast. Any emotional response is contained... the shift must go on. In a perfect world, there would be debriefing. The corporate masters deem we must continue to perform to their liking.