![]() ![]() She has written about performing chest compressions on a frail, elderly patient and feeling his ribs crack like twigs. Holland Kaplan, a physician and bioethicist, told me that "the bad experiences far outnumber the good ones, unfortunately." Another study linked intrusive memories and emotional exhaustion to difficult resuscitations. In 2021, a study found that 60% of providers experienced moral distress from futile resuscitations, and that these experiences were associated with burnout. Shots - Health News A Good Life And A Good Death: How Palliative Care Is Changing MedicineĬPR can be harmful not just for patients, but also for medical providers. About 30% of survivors of in-hospital cardiac arrest will have significant neurologic disability. Doctors are often able to restart a heart only to find that the brain has died. When cardiac activity stops, the brain begins to die within minutes, while the rest of the body takes longer. Two studies found that only 20-40% of older patients who survive CPR were able to function independently others found somewhat better rates of recovery.Īn even bigger quality of life problem is brain injury. The injuries sustained from the resuscitation can sometimes mean a patient will never return to their previous selves. ![]() It's not just a matter of life or death, if you survive, but quality of life. The traumatic nature of CPR may be why as many as half of patients who survive wish they hadn't received it, even though they lived. If your heart is resuscitated, you must contend with the potential injuries.Ī rare but particularly awful effect of CPR is called CPR-induced consciousness: chest compressions circulate enough blood to the brain to awaken the patient during cardiac arrest, who may then experience ribs popping, needles entering their skin, a breathing tube passing through their larynx. "Fractured or cracked ribs are the most common complication," wrote the original Hopkins researchers, but the procedure can also cause pulmonary hemorrhage, liver lacerations, and broken sternums. Chest compressions are often physically, literally harmful. One study found that less than 2% of patients with cancer or heart, lung, or liver disease were resuscitated with CPR and survived for six months.īut this is life or death - even if the odds are grim, what's the harm in trying if some will live? The harm, as it turns out, can be considerable. A study in Sweden found that survival after out-of-hospital CPR dropped from 6.7% for patients in their 70s to just 2.4% for those over 90. Survival after CPR for in-hospital cardiac arrest is slightly better, but still only about 17%. It was 7.6%.īystander-initiated CPR may increase those odds to 10%. In 2010 a review of 79 studies, involving almost 150,000 patients, found that the overall rate of survival from out-of-hospital cardiac arrest had barely changed in thirty years. Two bioethicists observed in 2017 that "CPR has acquired a reputation and aura of almost mythic proportions," such that withholding it might appear "equivalent to refusing to extend a rope to someone drowning."īut the true odds are grim. Those sound like good odds, and this may explain the attitude that everyone should know CPR, and that everyone who experiences cardiac arrest should receive it. ![]() In real life, people similarly believe that survival after CPR is over 75%. In 2015, researchers found that survival after CPR on TV was 70%. Many people learn what they know about CPR from television. "It seems too good to be true," he said, and it is. "This is the truest of emergencies and you give people the simplest of procedures," Timmermans told me. Life Kit Why writing a will and planning for your death is a 'lifetime gift' to loved ones Their excitement at its simplicity was clear: "Anyone, anywhere, can now initiate cardiac resuscitative procedures," they wrote. ![]() It wasn't until 1959 that researchers at Johns Hopkins applied the method to humans. The discovery that chest compression could circulate blood during cardiac arrest was first reported in 1878, from experiments on cats. CPR can sometimes save lives, but it also has a dark side. So why the controversy? It comes down to a widespread misconception of what CPR can, and can't, do. And according to family, the woman had wished to "die naturally and without any kind of life-prolonging intervention." But the woman was already dead - her heart had stopped. It made the local news, which elicited a national outcry and prompted a police investigation. "Is there anybody there that's willing to help this lady and not let her die?" the dispatcher said. The dispatcher instructed an employee to perform CPR, or cardiopulmonary resuscitation. "911 dispatcher's pleas ignored." Several days earlier, an elderly woman at a senior living facility had gone into cardiac arrest. "Nurse refuses to perform CPR," read the caption on an ABC newscast in California. ![]()
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