Realistic explanation of CPR

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Hello everyone, this is my first time posting.

I do admissions at a subacute rehab facility, and one aspect of my position is getting a code status signed. I see mainly older adult patients and their families; some who want everything done to their 80-90 year old family member who is frail and probably wouldn't survive. Often people will ask 'Will chest compressions break the ribs/do you have to break the ribs?' or I will also get asked 'Can you just use the paddles instead of doing compressions?' I tell them that more than likely the ribs will break, and there is no such thing as CPR without doing compressions. I feel like it does not always get the realistic picture across of what really happens during a code.

My question is how do you realistically explain CPR to patients and their families about ribs being broken and the logistics of what happens during a code? Thank you!

Specializes in Pediatric Critical Care.

Most families, whether they are ready to sign a DNR or not, know that they want their family member to have a peaceful and dignified end-of-life. One of the things that I tell them when they ask is that there are lots of things that we can do to help their family member pass away peacefully.

I also tell that that CPR is not a peaceful process. Sometimes using those key words like "peaceful" helps them realize that choosing to "do everything" for their family member doesn't really line up with those goals.

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Specializes in Healthcare risk management and liability.

Back when I was on the Medic One unit, if the family wanted to hear a realistic assessment of the patient's chances, I told them there was probably a less than 10% chance that the patient would walk out of the hospital neurologically intact.

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Specializes in Emergency.

Asystole is asystole and electricity won't do anything to start a heart that lacks it's own electrical activity. Here is a quick breakdown website that sums up:

Ventricular Fibrillation and Pulseless Ventricular Tachycardia | Learn & Master ACLS

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One of my favorite MD's I use to work with (when I did home hospice) when discussing code status with patients and families use to ask " So, what do you think would happen if your heart stopped, or your lungs quit working and someone did CPR on you?" ..... lots of times the response would be " Well, I'd be back at home in a few days, just like this" and discussion would result.

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3 things I include for this population are, (simple layman's term)

1) We treat medically to avoid the need for CPR

2) CPR is not prevention of death but an attempt to bring someone back, if the heart is already weak the success rate is poor

3) Quality of life will be worse than it is now.

I demonstrate the motion of chest compressions in there somewhere if I think it's needed.

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Specializes in 15 years in ICU, 22 years in PACU.

CPR, when appropriately used, is only done on dead people.

In BLS/ACLS class we are first trained to assess whether CPR is even needed by checking for consciousness, checking for breathing, THEN check for pulse.

If they respond to the shake/shout, rescue position ... no CPR.

If they are not breathing, rescue breathing only ... no CPR.

If they have no pulse, THEN we do CPR.

TV has really done a disservice to the public with regard to the miracle of "shocking the heart into restarting".

Just like time travel. We see it on TV / movies / games etc. but it ain't real. EVER!

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Greetings, everyone. I often read articles from this site although I am "only" a Good Amateur Nurse. The thread on realistic explanation of CPR is exactly what I've been looking for. I've told family members and close friends that I definitely want to be DNR. One family member has objected, asking "Why?" Now, thanks to the thread, I can print off your own knowledge to have that person read it. When I fall down dead, just leave me dead!! Thanks again.

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