Lost Cause? Perhaps not
Once I believed that when cardiopulmonary resuscitation(CPR) is performed, the fight for the patient's life is a lost cause, at least in adults. And when co-morbidities exist, the prognosis worsens further.
I once said that when CPR is commenced, 9.5 out of 10 patients will end up dying. It meant that CPR was a prelude to death. What more if the patient did not respond favorably to early resuscitative efforts.
It is true that CPR is never a good prognostic indicator for patients. But the chances of success is higher when performed promptly and correctly.
The gratifying feeling of saving someone you thought was certainly going to die, is beyond description. But it happened when a patient was brought in to the Emergency on one busy evening during on-call, with shortness of breath and went into cardiopulmonary arrest in the Emergency.
CPR was commenced. The patient's heart rhythm gave us a challenge from ventricular fibrillation to sinus bradycardia. He was defibrillated 3 times and given large doses of drugs. After a 15 minute struggle, we finally got a pulse but his rhythm remained unstable.
What was the chances of survival? I would not bet on it. I counseled the wife that we are probably going to lose him, and he was unlikely to survive the night.
He did survive the night. What surprised me was he finally got home. "What are the odds of that?" was my initial thought.
So the next time when I'm involved in a resuscitation attempt, it is never a lost cause, until it's lost.
I once said that when CPR is commenced, 9.5 out of 10 patients will end up dying. It meant that CPR was a prelude to death. What more if the patient did not respond favorably to early resuscitative efforts.
It is true that CPR is never a good prognostic indicator for patients. But the chances of success is higher when performed promptly and correctly.
The gratifying feeling of saving someone you thought was certainly going to die, is beyond description. But it happened when a patient was brought in to the Emergency on one busy evening during on-call, with shortness of breath and went into cardiopulmonary arrest in the Emergency.
CPR was commenced. The patient's heart rhythm gave us a challenge from ventricular fibrillation to sinus bradycardia. He was defibrillated 3 times and given large doses of drugs. After a 15 minute struggle, we finally got a pulse but his rhythm remained unstable.
What was the chances of survival? I would not bet on it. I counseled the wife that we are probably going to lose him, and he was unlikely to survive the night.
He did survive the night. What surprised me was he finally got home. "What are the odds of that?" was my initial thought.
So the next time when I'm involved in a resuscitation attempt, it is never a lost cause, until it's lost.
2 Comments:
true.
and you bring up a good point- pulses returning is one thing, but living to hospital discharge and having a good quality of life thereafter is another.
That's story will make me fight harder during CPR. :-)
Recently we had 2 CPRs in trauma patients. One went home but the other died.
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