Twice in the past month, I've participated in restarting a stopped heart belonging to someone over the age of 75. In both those cases, the patient never regained consciousness, and passed away in the ICU a few days later. This story repeats itself over and over again... I don't know what the actual percentage is, but the number of elderly patients who are 'resuscitated' only to never wake up again is surely north of 99%.
I'm conflicted about my participation in this process... CPR is a very brutal process, and all the interventions we use to restart someone's heart are equally traumatic.
So, why do we do this? In most cases, it's because someone doesn't have a DNR, or any other sort of advanced directive. In most (all?) states, if you call EMS and don't have a DNR, you need to actually threaten us to absolve us of our legal duty to start resuscitative efforts (in reality, most of us are human beings, and simply explaining the situation should be enough). The other situation is when a patient _does_ have a DNR, but the family is insistent that we "Do something!"
In both of my recent experiences, our efforts kept the patient 'alive' long enough for out of town family to travel back to say their goodbyes.
Was it worth it though? The financial, emotion, and physical costs are pretty high... I'm not sure...
I'm conflicted about my participation in this process... CPR is a very brutal process, and all the interventions we use to restart someone's heart are equally traumatic.
So, why do we do this? In most cases, it's because someone doesn't have a DNR, or any other sort of advanced directive. In most (all?) states, if you call EMS and don't have a DNR, you need to actually threaten us to absolve us of our legal duty to start resuscitative efforts (in reality, most of us are human beings, and simply explaining the situation should be enough). The other situation is when a patient _does_ have a DNR, but the family is insistent that we "Do something!"
In both of my recent experiences, our efforts kept the patient 'alive' long enough for out of town family to travel back to say their goodbyes.
Was it worth it though? The financial, emotion, and physical costs are pretty high... I'm not sure...