Monday, June 1, 2015

CPR

We retrain and recertify on CPR every year. It's a huge deal conducted by one of the local ambulance companies. The sessions are replete with creepy rubber dummies of various ages and genders, with movable mouths (oh, grow up!), compressible chests, and chests that expand as you inflate the "lungs".

When you work this job, you can be guaranteed you'll be called on to use this skill set. I've CPRed everything from a 16 year-old high school athlete who suddenly dropped dead, to a 90+ year-old WWII combat vet who keeled over while visiting his son.

And it almost never works. I've heard CPR has a success rate of about 10%, but my experience isn't nearly that high. When we arrive on scene and you're dead, you almost always stay that way. Fire and ambulance may do a little better - they have a lot more gear and meds - but I bet it isn't by much.

Which brings me to this:

I do a welfare check on a guy, called in by his roommate. History of depression, drug abuse, previous suicide attempts, etc. I walk around the house, banging on doors and windows, and get no answer. Given what little I know at this point, I don't have PC to knock the door down. I don't even know if the guy is home. Just as I'm leaving, the roommate shows up and lets me in. He directs me to the guy's bedroom.

I push the bedroom door open and shine my flashlight onto the bed. There he is, on his back, head on a pillow, blanket pulled up to his chin. And I know as sure as I'm standing there, just from the color of his skin, that this guy's dead. The bedside table is littered with pill bottles, and there's actually a handwritten list of the types and amounts of meds he's taken.

I call his name several times - nothing. I put my face next to his to listen/feel for breathing - nothing. I check for a carotid and brachial pulse - nothing. I pull his shirt up and put my ear directly onto his chest to listen for a heartbeat - nothing. But I do note that he's still warm to the touch.

So, I drag him off the bed and onto the floor, call out the code on the radio, and start CPR. I must've been at it a good five minutes when the ambulance crew comes barging in. They start hooking up all their electronic crap and strap a bag on him, while I continue chest compressions. They finally have me stop while they check their gizmos, and guess what? Heartbeat!

He's still not breathing on his own, so they turn over the bagging to me (I felt like Dr. Kildare, squeezing that thing), while they continue whatever it is they do. Finally, they get him breathing, load him up, and haul him off. And I go off to the next call - probably a rabbit stuck in a window well or something equally exciting.

Later that day, I get word the guy has survived. Days later I learn he went home from the hospital. A few weeks after that, he tried it again. I heard he survived that too, but I wasn't working that day.

8 comments:

awesomesauciness said...

It does work..sometimes...and you should be proud of yourself.

Sadly, he may succeed in one of these attempts, but maybe...just maybe...the borrowed time you gave him will make a difference.

iratecanadianpharmacist said...

I believe the 10% statistic includes hospital setting which has a faster response time. Even then, TV medicine I feel has raised all our expectations to it's effectivness. Meanwhile, my only successful resuscitation turned out to be a DNR patient :s

As a former CPR instructor, I always found funny the prenatal classes, just because the mothers were 5000 times more likely to need it for their husbands than their child.

Anonymous said...

I've read that even when CPR is successful in the sense that the person survives, there are physical & mental problems to the point where doctors joke that they are going to have DNR (do not resuscitate) tattooed on their foreheads.

migraineur said...

I'm almost at the not joking, gonna tattoo DNR/DNI (do not intubate)...if I weren't do scared of needles. Poking you, no prob, getting stuck, giant wuss
The Resp Therapist

Anonymous said...

Successful CPR can still leave people with brain damage from lack of oxygen, but it's not to the point where you'd withhold CPR to avoid it. I'm guessing the DNR comment from doctors comes from the experiences all of us in emergency medicine have had, where we're basically just breaking the ribs of some poor elderly person who's basically already dead.

With that said...in 10 years as an EMT, I've had CPR work once, on a child. She survived and went home after getting the medical condition that caused the problem corrected.

Dana said...

The numbers are more 3% unwitnessed out of hospital.. 6% in hospital.. Not good numbers.. And out of hospital is with AED's!

Mark p.s.2 said...

The shrinks convinced the suicider he was diseased. Only the suicider can figure out what is true or not. You are what you do. If you do nothing, you are nothing.

You giving someone a second chance to live was a great job.

Mark p.s.2 said...

A dark comic on the disease of mental illness and the need of a cure. ( sarcasm)

Suicide vaccine