Patient waking up during CPR

Long Term Care Columnist / Guide · Jun 7, 2018

I let the mods know about the duplicate posts. They'll take care of it for you.

I once took care of a young (mid-40s) patient who had coded in the ER. He remembered a lot of it---how it felt when they shocked his heart, watching himself being worked on by the code team, even throwing up. He was glad to be alive, to be sure, but I've always wondered if he didn't suffer a little PTSD from the experience. I think I would have. He had a lot of philosophical and spiritual questions that I of course couldn't answer; thank God for the hospital chaplain! I think of him every now and again and wonder how he is.

Been there,done that, ASN, RN · Jun 7, 2018

The CPR must have been effective. If he woke up... time to stop.

MunoRN, RN · Jun 7, 2018

Effective CPR that's started immediately after cardiac arrest should perfuse the brain enough for the patient to have at least some degree of consciousness. When a patient has an art line in, we typically expect to achieve normal blood pressures. I've done CPR on a number of patients who are fully awake while chest compressions are in progress despite having no intrinsic cardiac activity during pulse checks and bedside echo.

Silverdragon102, BSN · Jun 7, 2018

Threads merged

AnnieOaklyRN, BSN, RN, EMT-P · Jun 7, 2018

My hospital has seen that more than once when they have used the Lucas device for CPR. They have had to give patients sedation!! Unfortunately as soon as you shut it off they are unresponsive without a pulse again, it's kind of a weird thing. You essentially have to tell them they are dead while you are doing CPR and that you cannot save them.

We have the Lucas on the ambulance too, but I have yet to see that happen.

Annie

Wuzzie · Jun 7, 2018

I cannot imagine the emotional toll these events have on everyone involved.

elkpark · Jun 7, 2018

Excuse me for sounding glib, but isn't the whole point of CPR for people to "wake up"?

Wuzzie · Jun 7, 2018

Excuse me for sounding glib, but isn't the whole point of CPR for people to "wake up"?

Well yes, if the "waking up" becomes a permanent state. But being awake only while compressions are being performed and no return of spontaneous cardiac activity must be just awful for everyone.

RobbiRN, RN · Jun 7, 2018

People can fade in and out more than once during a resuscitation, or just pop "awake." I've had two patients talk within a few seconds after being shocked out of a pulseless v-tach. One sat up and said, "I can't believe this is happening to me. ER is my favorite show." She went back into v-tach and became unresponsive just seconds after her announcement.

PCnurse88 · Jun 7, 2018

The very first time I did CPR the patient woke up and immediately grabbed me while I was doing compressions. I was so shocked the only reason I didn't fall off the bed was because the chief resident was standing next to me and had a hand on my back to steady me (I was kneeling on the bed). Patient went unresponsive as soon as I stopped compressing and we couldn't get a pulse, so CPR was resumed. Again, patient woke up and stared straight at me as I did CPR. Ended up calling it after 30 minutes. I will definitely never forget that experience.

NuGuyNurse2b · Jun 7, 2018

The very first time I did CPR the patient woke up and immediately grabbed me while I was doing compressions. I was so shocked the only reason I didn't fall off the bed was because the chief resident was standing next to me and had a hand on my back to steady me (I was kneeling on the bed). Patient went unresponsive as soon as I stopped compressing and we couldn't get a pulse, so CPR was resumed. Again, patient woke up and stared straight at me as I did CPR. Ended up calling it after 30 minutes. I will definitely never forget that experience.

Awwww that would stay with me, too.