Time spent on resuscitation of a celebrity

[DuluthMike]

With the passing of Michael Jackson today I had a question of when is enough in the resuscitation of a celebrity. Apparently there had been well over an hour of resuscitation attempted on Mr. Jackson. This started well past when his heart initially stopped. When Princes Diana died, over an hour was spent attempting to resuscitate her, including open chest heart massages. What is the point of spending that long attempting to bring someone back who has been down for such extreme lengths of time? Such lengths are warranted in cases where cold is involved and the body and brain are protected, but what is the point of spending an hour to bring someone back who has no chance of revival without total brain death? Is this to prevent lawsuits? Perhaps is it our inability to allow those whom we hold in such high regard to pass when it is obvious to someone outside of the situation that they are gone?

[GadgetRN71, ASN, RN]

This just doesn't happen with celebrities...I've seen many codes well over an hour long.

I participated in one in the OR a few years ago on a 78 year old guy! He lived and 4 days later was sitting up in bed talking with family. That was freakin' awesome.

[Zookeeper3]

An hour is not unusual, we have MD's who will code for several hours and empty several crash carts. plus MJ was only 50, I think an hour is a fair amount of time to be certain everything has been attempted.

[SweetLemon]

Interesting that this question was posted I was actually thinking about it as I was sitting watching the CNN coverage (why is it that even though all they do is repeat the same information over and over again you still can't change the channel). I would imagine it would be a very hard call to make. Not only because of the celebrity status but also because leaving anything left questionable would no doubt bring on legal implications in such a high profile case.

[gonzo1, ASN, RN]

Hard to imagine such a talented and famous person laying on table getting foley, ribs cracked, God knows what else. Not a very glamorous way to go out.

Can't believe Liz Taylor out lived him

Mostly I just feel sorry for him

Hard to believe him and Farrah went out on the same day.

[blondy2061h, MSN, RN]

We had one patient we coded for 3 hrs. And it was her 4th time coding (the other 3 on previous admits). And she made it and it doing well.

[Southern Fried RN]

I had a 19 yr old multiple drug OD patient, down for unknown time @ home and the ER worked on her for 2 hours. She stayed in our ICU for months on the vent, was on dialysis, finally got better and then went to rehab. Today she is doing great, some cognitive deficits but has cleaned up her life and is now a mom.

[Teresag_CNS]

I think you nailed it with "Perhaps is it our inability to allow those whom we hold in such high regard to pass when it is obvious to someone outside of the situation that they are gone?"

Imagine being the doc who let Michael Jackson go after 20 minutes of resuscitation attempts; painful questions can be avoided by sticking it out for 60 minutes, which I agree is well beyond the usual length of a resusc. attempt, and does nothing to increase the odds of survival.

[fins]

One other thing to consider is that time just flies in a code (sometimes.) You look down, and although it seems like you haven't done anything but two rounds of compressions, when you look up an hour has gone by. An hour-long code can seem like the blink of an eye.

[kcochrane]

I was a EMT for over 15 years and spending an hour is not uncommon - especially if you are out in the field. I don't believe his celebrity status had anything to do with it.

[VivaLasViejas, ASN, RN]

I don't think I've been in a code that lasted under an hour, except for my very first, which was an ancient ORIF patient whose BP tanked four hours post-op. I think I broke every rib she owned with the first few compressions. She never had a chance, and the doc mercifully called it within fifteen minutes.

The longest code I've been involved in was a 42-year-old man whom I was admitting one afternoon. He had come into the hospital AA&O, if a little short of breath and anxious (he had a type of congenital heart defect that had tragically taken the lives of his father at 48 and his little brother at 36). Suddenly he went from being pink and freckle-faced to grey, then blue, then purple in a matter of seconds as his nurse and I called the code. His last words, puffed out in staccato bursts as he slipped into unconsciousness, pleaded with us: "Please. Don't. Let. Me. Die. My. Kids. Are. Here."

We tried......oh, God, how we tried. In the middle of coding him we transferred him to the ICU and continued our desperate attempt to save him, despite having technically turned over his care to the nurses, RTs, and doctors there. But after everything we had on hand had been tried and he remained that ghastly cyanotic hue, the cardiologist called it. We all looked up at the clock, and were shocked to see that over three hours had passed; and all we had to show for our efforts were exhaustion and aching shoulders. The man's wife and his 10-year-old and 7-year-old kids were waiting down the hall..........it was awful, and in some ways it will haunt me for the rest of my life.

I tell that story not because I enjoy remembering it, but to show that we give our best efforts to everyday heroes, not just the rich and famous.

[kcochrane]

A little more info that is interesting:

When Michael Jackson went into cardiac arrest, rescuers took him to a place known for bringing the dead back to life. A world-renowned surgeon at the UCLA Medical Center has pioneered a way to revive people that most doctors would have long written off, including a woman whose heart had stopped for 2 1/2 hours.

Tested on a few dozen cardiac arrest patients, 80 percent survived. Usually, more than 80 percent perish.

Full article here:

http://www.rr.com/news/news/article/1500/8226561/Jacksons_hospital_is_known_for_raising_the_dead