This week I would like to write about CPR. I feel it is widely misunderstood and hope to bring some clarification on this sensitive topic. As a nurse who deals with the many aspects of CPR I hope to help the public understand why nurses and doctors must ask questions about people's wishes. I find patients seem to feel threatened and offended by the subject. Again I remind all readers that this column is my personal observations and not my family's, employer's or co-workers.
CPR stands for cardio -pulmonary resuscitation. In other words manual stimulation of the heart lungs. There are lots of reasons why the heart may stop pumping such as: trauma {hit hard enough ], disease, electricalshock, congenital defect, blood loss[not enough blood to pump], over
exertion[shoveling], or it is old and worn out.
Statistically the chances of successfully performing CPR and someone being brought back to life when the heart has stopped is very low. The latest percentage I am aware of is under 10%. Several years ago I became a CPR instructor but before that time I was not aware of the low odds. As a young nurse I assumed if CPR was started in a timely manner that chances of reviving someone were good! Over my 35 year career I have done CPR on many occasions. I would guess a couple of dozen times always in a hospital where all medical resources are available. By this I mean heart monitors, doctors, and heart medications. I have only seen one person successfully revived.
This patient was in hospital and CPR was started within minutes and then defibulated. He was in the right place at the right time.
Automatic defibrillators are a wonderful option and definitely lead to more success.This is why we are seeing this machine more available such as in rinks, cassino's, as well as other public buildings. Please take note of them and remember that they are there for the public use. They are designed so not to need education to use. As long as you can read the instructions on the screen the machine will tell you what to do. In fact it will tell you if you should not use it according to what it reads for a heart rhythm.
Now that I work in a Long Term care facility the question of CPR is even more relevant . As we age we become closer to our death. Remember it does not mean we expect you to die or that we wish you to die but rather if you should die of natural causes do you want an attempt to be made to revive you. My own Father choose not to be resuscitated when he was dying of cancer and accepted deathwas inivitiable. Health professionals are legally obligate to start CPR whether you are nine or ninety nine. We can not make the assumption that you are ready to die . When someone collapses in a public place it will be assumed you would choose life. Remember since this person has died there is no worry that you may inflict further harm. Broken ribs would be the lest of their worries. So when you are asked if you wish CPR it is an opportunity to communicate. If you are suffering a life threatening disease you may wish a Do Not Resuscitate [DNR] that staff must also follow. Unless you have communicated this with your health professionals then CPR will be automatically performed.
I hope this will begin some thought to what you expect and I would encourage you to talk to your family and your doctor . Make an informed decision about your life and death.
