CPR propaganda or fact ?

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Grizz
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CPR propaganda or fact ?

Post by Grizz »

https://www.npr.org/sections/health-sho ... during-cpr
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Screenshot 2023-05-29 183134-CPR mis dis in formation.png
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what is true? what is not?

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Old Savage
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Re: CPR propaganda or fact ?

Post by Old Savage »

It has never been good and they have changed it a number of times in the years I have been involved. A police officer friend did it 6 times all expired. Unless you are in a hospital or maybe have the EMTs right there it is a long shot.
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44shooter
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Re: CPR propaganda or fact ?

Post by 44shooter »

It is a desperation measure with a low success rate and often causes multiple rib cage fractures. Context of the condition of the patient is everything. My mentally disabled uncle was resuscitated and had broken ribs. He later had DNR orders as he had a terminal condition he died from a few months later. I would want CPR as I’m a fairly healthy 52 year old that probably has the time and strength to recover. I wouldn’t want my ailing grandmother to go through it.
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Re: CPR propaganda or fact ?

Post by gamekeeper »

Thanks for posting Grizz, I didn't know the survival rate was so low.
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Re: CPR propaganda or fact ?

Post by GunnyMack »

I knew a guy with colesterol well higher than extremely high, it was normal for him, a medical anomaly. One day he fell over dead at work. They kept cpr going all the way to the hospital. He was declared dead and a few hours later in the morgue he sat up and walked away! Scaring the bejeebers out of the coroner .
I can see cpr if a heart stops but it won't do much for an aortic aneurysm or stroke or any number of medical conditions- the public doesn't know a particular medical history for a person that keels over at the mall.
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stretch
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Re: CPR propaganda or fact ?

Post by stretch »

https://www.zocalopublicsquare.org/2011 ... eas/nexus/

This is a VERY interesting essay - I first read it some years back.

CPRs is, apparently, WAY overrated. The success rate is very low, and when done correctly, especially in the elderly,
causes painful broken ribs.

-Stretch
Bill in Oregon
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Re: CPR propaganda or fact ?

Post by Bill in Oregon »

Stretch, thank you for that link. Very important reading.
I took a CPR/first aid refresher a couple of years ago in El Paso, and it was made clear that even using the best technique, CPR results are usually discouraging PLUS the attendant ribcage damage.
A hiking friend in New Mexico related the ultimate CPR nightmare: Four of them were hiking along a high ridge in the Sacramento Mountains just east of Alamogordo when the hike leader simply "dropped dead."
The other three began CPR and kept it up for nearly an hour before the victim could be removed by helicopter. He was still dead and the CPR-givers were traumatized for quite some time after.
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Grizz
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Re: CPR propaganda or fact ?

Post by Grizz »

the breathing form of CPR can and will save lives. i helped with a drowning victim who was blue in the face, but is now a healthy human with family and friends . . . this works because it keeps air available to the brain, his heart restarted with a little spurt of water. the syndrome is called cold water drowning, but does it also work for "adult sudden death syndrome"?
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Re: CPR propaganda or fact ?

Post by Gunstore Commando »

[[I joined a while ago, I guess, just never had anything to say before...]]

...anyway...

One thing to consider is the feelings of the family. Even if the patient does not survive, if everything is done right, at the end of the day, some physician gets to look the family straight in the eye and say "everything possible was done to save your family member".

I know two different families whose perception, rightly or wrongly, is that their family members did not receive appropriate care in a cardiac arrest. Not related to any agency I am part of, just people I happen to know in my personal life. I wasn't there and have no idea what actually happened, but this was a very tough thing for those families to deal with.

You don't want people to go through life thinking that their son, husband, mother, etc., might still be alive if things had been done correctly.
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Re: CPR propaganda or fact ?

Post by jeepnik »

My percentage is well above the figures listed. Remember what the man said “There are three types of lies. Lies, darned lies and statistics”. So you can take the numbers quoted with a grain of salt.

By the way 150,000 out of the entire population is statistically insignificant.

Does it work? Sometimes yes sometimes no. Are there potential adverse side effects? Again, sometimes yes sometimes no.

Add to that some folks have DNR’s. But you don’t always know that. And listening to family members to not resuscitate is a fool’s errand. They may be motivated by factors other than the patient’s wishes

I could go on and on but it comes down to one simple question. Can “you” stand by a watch someone die without trying to save their life.

But think about this. If you try and fail you have the knowledge you tried. If you do nothing you will likely be haunted by the fact that you didn’t even try. You’ll never know if they would have survived.

If you can live with that, so be it. I’m not built that way.
Last edited by jeepnik on Tue May 30, 2023 3:16 pm, edited 2 times in total.
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Re: CPR propaganda or fact ?

Post by TraderVic »

Infant CPR is real scary sensitive. Short, small breaths or you'll rupture their lungs.
765x53
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Re: CPR propaganda or fact ?

Post by 765x53 »

So, "New York City CPR" works as well as Red Cross CPR? :)
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Re: CPR propaganda or fact ?

Post by Bill in Oregon »

Excellent point, Jeepnik.
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Re: CPR propaganda or fact ?

Post by GunnyMack »

Then there is the legal quandary- you give cpr but the brain dies, or broken ribs that lacerate a lung, now the family sues and you have to defend your actions in the hopes of being a decent caring human- and who wins? The lawyers!!
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jeepnik
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Re: CPR propaganda or fact ?

Post by jeepnik »

GunnyMack wrote: Tue May 30, 2023 2:51 pm Then there is the legal quandary- you give cpr but the brain dies, or broken ribs that lacerate a lung, now the family sues and you have to defend your actions in the hopes of being a decent caring human- and who wins? The lawyers!!
Nope! Every state has "Good Samaritan" laws that prevent you from being sued as long as you are trying to render aid. Heck, there have been cases where families have tried to sue because no one tried. Those suits didn't go anywhere because civilians are not required to render aid. But like I said, if you can live with the guilt, go for it.
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Re: CPR propaganda or fact ?

Post by GunnyMack »

Ah, did not know that !
I've never been in that situation, don't want to be in that situation but if I was I'd try my best!
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Re: CPR propaganda or fact ?

Post by elmo123 »

I stopped counting at 12 times but I probably performed CPR over 30 times. We were already on the street and were dispatched on all of the ambulance calls to guard the ambulance.

One day I had a sudden death call involving an infant and I got a faint heartbeat but it didn't last. As soon as I was done with that call I had another one involving an elderly woman who had stopped breathing, CPR didn't help her either. It definitely made the family members feel better but I never saw anyone saved by CPR.

There is nothing as shocking as breaking the sternum and rib cage when you start chest compression's.
lthardman
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Re: CPR propaganda or fact ?

Post by lthardman »

After nearly 30 years as a Medical First Responder and firefighter, I have performed CPR more times than I can count. Some comments:

First, not all CPR is the same. The CPR you see on TV is a joke. It is never depicted realistically. High Quality CPR has a higher probability of resulting in the return of spontaneous circulation (ROSC). On an adult, the chest should be compressed at least two inches. They never do that in TV in fear of causing injury to an actor. And, the chest must be allowed to fully recoil after each compression so the heart can fill with blood. The rate of chest compressions should be 100 - 120 per minute. Those are three of the critical elements of High Quality CPR. And that is rarely if ever depicted on TV.

Second, the purpose of CPR is to supply the brain and other vital organs with oxygenated blood until such time the heart can be caused to start pumping effectively. Without CPR, brain tissue begins to die after four minutes without an effective pulse. High Quality CPR extends that time. Rarely does CPR, by itself, result in the return of spontaneous circulation. But it does extend the time that a person can be resuscitated - thus giving those with higher levels of training and expertise more time to arrive.

Third, the probability of High Quality CPR resulting in ROSC is greatly enhanced when combined with an AED, an automated external defibrillator. That said, it is important to note that the most recent protocols call for two minutes of High Quality CPR before using an AED. The High Quality CPR conditions the heart to receive the shock and cause it to restart in a normal sinus rhythm.

Fourth, paramedics often carry some narcotics that can prove to be very valuable when combined with High Quality CPR and an AED. And, many jurisdictions now have access to a LUCAS device, which has also proven to be a great advantage.

Fifth, there can in fact be rib or sternum damage to the patient as a result of CPR. That said, people recover from rib or sternum damage. They do not, however, recover from a heart that does not return to spontaneous circulation.

Finally, nothing will ever save everybody. People die. God decides. When someone is saved and 'heroic measures' were used, God decided they should survive. And when someone dies despite heroic measures, God decided that as well. It took me a long time to fully understand that. But that understanding has allowed me to do this job for nearly 30 years. I am proud to say that, working as a team, my department has participated in very many successful resuscitations. A whole lot. Our success rate is much better than that quoted above. Because God decided it should be.
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Re: CPR propaganda or fact ?

Post by Walt »

I performed CPR on a number of occasions as well. Sad to say, the greatest success was with drug overdoses whose hearts had apparently not completely stopped but were immeasurably slow and weak.

I remember on one of my first calls with the ambulance company, I was instructed to perform CPR regardless whether the patient, an intoxicated woman who had been run over by a car, was alive or obviously dead. I followed instructions; her husband for whatever reason had been allowed to ride in the front seat of the ambulance and was constantly looking back through the window.
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Re: CPR propaganda or fact ?

Post by Walt »

My time with the ambulance company was well over 50 years ago. Enormous strides have been made since then in training and equipment. Despite being the "frontier days" of picking up patients and hauling tail to a hospital while providing the most rudimentary care, I believe I had a part in helping a lot of people out of the very lowest points in their lives.

God bless first responders! I admire them one and all.
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Re: CPR propaganda or fact ?

Post by Rockrat »

Performed CPR once before, on a friend of mine involved in a motorcycle accident. Was told later that if he had wrecked outside a level iv trauma unit, he still would have passed. Still haunts me somewhat, but would still do it all over again.

Heard child cpr is the toughest
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Re: CPR propaganda or fact ?

Post by KWK »

A few years back, a newspaper piece by a doctor claimed the life expectancy of someone revived by CPR was about 30 days.
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Re: CPR propaganda or fact ?

Post by piller »

Never needed to give CPR. I have had a defibrillator used on me. It didn't work. Time of death was called. An hour or 2 later, the nurse had cleaned me up, bagged my stuff, and was waiting for the morgue to come get me when I started breathing again. I was told she screamed and ran out of the room. I was also told later that I was at room temperature. When I was discharged a few days later, the Doctor who filled out the death certificate pushed the wheelchair to my Son's car. The Doctor said I was the only dead person he had ever seen get up and walk to a car. I lost a tiny bit of memory, but most of it has come back. I cannot read books word for word or draw detailed maps from memory anymore.
By the way, the defibrillator leaves a sunburn on you. It hurts later.
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Re: CPR propaganda or fact ?

Post by Walt »

That's miraculous, Brian! I'm glad you're still with us.
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Re: CPR propaganda or fact ?

Post by Gunstore Commando »

At risk of stating the obvious, the phenomena that piller experienced is poorly understood. Here's a recent article about it.

https://www.ems1.com/medical-treatment/ ... 9As8diGUq/
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Re: CPR propaganda or fact ?

Post by piller »

It has been 4 years since that incident. Waking up at room temperature is no fun. You are so cold that your teeth cannot even chatter. Nothing moves, and you cannot think.
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Re: CPR propaganda or fact ?

Post by Woodtroll »

The success (or not) of CPR depends in large part on what caused the heart to stop pumping normally in the first place, and also how quickly aid is initiated. Near-drownings, electrocutions, and some narcotics overdoses, for example, are traumatic events but usually involve a healthy heart that needs a little help (oxygen, cardioversion, or Narcan) to get going again. Most folks "drop dead" from massive heart attacks, strokes, aneurysms, or something similar. These patients and ones who suffer massive trauma are not good candidates because something has gone badly wrong with their cardiovascular system, and just "working the pump" through CPR does not affect the underlying cause of their death.

CPR does work, under the right circumstances, and the small success rate does matter (hugely!) to the small percentage who recover. It certainly is worth an attempt in most cases, if only to try to buy time to treat any correctable underlying causes. I've never known anyone to guarantee that CPR was 100%, or even 25%, effective - unless you are foolish enough to believe the TV shows. Some folks look for (and find) conspiracies where there were never any to begin with.
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Re: CPR propaganda or fact ?

Post by piller »

Mine was from kidney failure, ketoacidosis, and blood sugar level of almost 1,000. All caused by Metformin.
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