Old lady dies in nursing home because Nurse refuses CPR, cites company policy.

[MattB]

I don't condone how the nurse handled it, but yeah, I'm right with you. If I have to live in a home at 87, let me go the first chance I stop ticking.

That's exactly what we did with my grandfather, signed a DNR. Even the nicest nursing homes are just shitty places to leave a loved-one.

[lowthreeohz]

I really need to brush up on my CPR skills. I haven't done it in years.

AHA calls it "hands only cpr" now... just chest compressions. I think they found that there is sufficient blood oxygen saturation for a short time and breaths dont really add anything...if i'm wrong Tim will correct me.

[Forever_frost]

I really need to brush up on my CPR skills. I haven't done it in years.

[Frank]

Fuck, if I make it to 87, don't try CPR on me either, whether or not I need it.

I don't condone how the nurse handled it, but yeah, I'm right with you. If I have to live in a home at 87, let me go the first chance I stop ticking.

[inline 6]

I think the nurse may have been in the right by not ginger judy chopping the ole lady's chest to perform CPR. It is brutal and would more than likely done more harm than good. On the other hand she handled the phone call and situation piss poorly.

[Sean88gt]

Would nurse responsibilities supersede company policy? Sick world we live in.

[Probie]

No pulse you start chest compressions, not hook up AED. ACLS says you chould always start chest compressions while scrambling for an AED. In fact, gone are the days of ABC, and now it is CABC with compressions being the most important. Irving Fire Department was doing a test and last I heard, there were better outcomes with 10 min of chest compressions before trying to intubate.

I was already doing compressions when I told somebody who was standing around to hook up the aed.
Guess I left that part out. I edited it.

[8mpg]

For something like a <10% chance of saving her. Even if you did, you are breaking several bones and possibly puncturing the lungs of an 87 year old.

Not sure where I stand here, but I'm leaning towards giving the "nurse" a break.

CPR is brutal and people just dont get it. We bring in families as we do CPR at times and when they see the brutality, they sometimes changes their minds.

I see it like this. As already stated, sue happy Americans.

Different scenario, but same result. What would you do???

Car wreck, car rolled, driver stuck inside, upside down and is held in by his seat belt. Would you try and get them out if you thought the car would catch fire? What if they have a neck/back injury, and sue you because you made it worse and the car didn't catch fire?

When something like that actually happens, you can't tell how you'd react. Sure, we think "I woulda done so and so", but until you are actually faced with it, you can't be sure what you'd do.

Good Samaritan will protect most people, but people in the medical field are held to different standards as their knowledge base is higher. That being said, nurses are not trained to pull people out of cars, so you are on the fence. Are you protected by Good Samaritan or are you held to your medical degree?

I've dealt with that scenario, well one close to it. A white small car was in a sandwich between two semis after the truck behind didn't see the group in front stopping. There was a fire but it's not really a thought. You get in there and try to break the door loose to get them out. If they're paralyzed later, well fine, they didn't burn to death.

Some people just are pre-programmed to move towards things going wrong and try to make it right and some people just lock up.

Edit: When I hear gunshots I still haven't figured out how to make my first response be to duck

Would you rather be a vegetable paralyzed from the neck down or dead? Hard to say in each scenario.

The other day in my EMT class we were doing a car crash simulation ( parent in worst condition, kids in the car were just bruised up and fine). The way it was set up is there were four ambulance crews, the next comes onto the scene when the one before them calls for support. I was in the fourth ambulance crew with two other people. We get the call to go outside and when we get there all the kids are loaded up onto stretchers and we are left with the parent. We start get the patient onto the backboard. Our instructor then calls out that the patient has stopped breathing but still has a pulse. The other two people just look at each other. I'm already opening the airway and grabbing a bvm while one starts doing compressions. My instructor immediately asks them why they are doing that. They can't answer and he explains that you don't do compressions on a patient with a decent heart rate (was 60bpm steady but weak). So we get the patient loaded up onto the striker and while waiting for the ambulance. While waiting ( I am still ventilating). The instructor says the patient has lost their heart beat. Once again my partners just look at each other. I put down the bvm tell them to get the aed ready and for the other one to ventilate. The person putting the aed on PUT THE PADS RIGHT ON TOP OF EACH OTHER BECAUSE THE PICTURES TOLD HIM TO. And the other one is trying to ventilate the patient while I am doing compressions at around 30 breaths per minute. Patient died, I got an A my partners failed. Long story short, some people just can't handle pressure. Some people just shouldn't be in EMS, same goes for the kid that puked during the birthing video.

/rant

No pulse you start chest compressions, not hook up AED. ACLS says you chould always start chest compressions while scrambling for an AED. In fact, gone are the days of ABC, and now it is CABC with compressions being the most important. Irving Fire Department was doing a test and last I heard, there were better outcomes with 10 min of chest compressions before trying to intubate.

8mpg, isn't it like really, I mean like REALLY low chances that you are going to live anyways if you are down to CPR as a way to be saved?

Its always pretty shitty. Last I heard it was 1% from bystander out of hospital CPR. If you have an experience crew with no equipment, it is slightly higher out of hospital. Most people are fucked. We get lots of CPRs from the airport and througout Irving and have very poor results. Even with hypothermia protocols, most people end up with brain damage.

[krazy kris]

I was fortunate to have someone at the track that knew CPR after I had a YZ400f land on me. I was 14 riding a 125 and they had all the bikes practicing togeather, dumbest thing ever. They closed the weatherford track about 2 months later after a kid died.

[46Tbird]

8mpg, isn't it like really, I mean like REALLY low chances that you are going to live anyways if you are down to CPR as a way to be saved?

There is a ~3.3% success rate for CPR on people 80+ according to this article.

http://newoldage.blogs.nytimes.com/2012/08/09/how-successful-is-cpr-in-older-patients/

[inline 6]

8mpg, isn't it like really, I mean like REALLY low chances that you are going to live anyways if you are down to CPR as a way to be saved?

[Probie]

I laughed...hard. They better look into a new profession and fast if they cannot successfully complete something that basic.

It's just frustrating. It's extremely basic stuff, I was in disbelief.

I gotta get back to studying I have an exam tomorrow.

[downshift_me]

The other day in my EMT class we were doing a car crash simulation ( parent in worst condition, kids in the car were just bruised up and fine). The way it was set up is there were four ambulance crews, the next comes onto the scene when the one before them calls for support. I was in the fourth ambulance crew with two other people. We get the call to go outside and when we get there all the kids are loaded up onto stretchers and we are left with the parent. We start get the patient onto the backboard. Our instructor then calls out that the patient has stopped breathing but still has a pulse. The other two people just look at each other. I'm already opening the airway and grabbing a bvm while one starts doing compressions. My instructor immediately asks them why they are doing that. They can't answer and he explains that you don't do compressions on a patient with a decent heart rate (was 60bpm steady but weak). So we get the patient loaded up onto the striker and while waiting for the ambulance. While waiting ( I am still ventilating). The instructor says the patient has lost their heart beat. Once again my partners just look at each other. I put down the bvm tell them to get the aed ready and for the other one to ventilate. The person putting the aed on PUT THE PADS RIGHT ON TOP OF EACH OTHER BECAUSE THE PICTURES TOLD HIM TO. And the other one is trying to ventilate the patient while I am doing compressions at around 30 breaths per minute. Patient died, I got an A my partners failed. Long story short, some people just can't handle pressure. Some people just shouldn't be in EMS, same goes for the kid that puked during the birthing video.

/rant

I laughed...hard. They better look into a new profession and fast if they cannot successfully complete something that basic.

[Probie]

Most people freak out and dont know what to do. Its a normal response to intense stress in these situations. I work as a nurse in a hospital and I cant tell you how many times a room of med/surg nurses stand there with a blank face because they freak out and hesitate.

This is why certain people are trained properly to handle these situations, ie EMS.

The other day in my EMT class we were doing a car crash simulation ( parent in worst condition, kids in the car were just bruised up and fine). The way it was set up is there were four ambulance crews, the next comes onto the scene when the one before them calls for support. I was in the fourth ambulance crew with two other people. We get the call to go outside and when we get there all the kids are loaded up onto stretchers and we are left with the parent. We start get the patient onto the backboard. Our instructor then calls out that the patient has stopped breathing but still has a pulse. The other two people just look at each other. I'm already opening the airway and grabbing a bvm while one starts doing compressions. My instructor immediately asks them why they are doing that. They can't answer and he explains that you don't do compressions on a patient with a decent heart rate (was 60bpm steady but weak). So we get the patient loaded up onto the striker and while waiting for the ambulance. While waiting ( I am still ventilating). The instructor says the patient has lost their heart beat. Once again my partners just look at each other. I put down the bvm and start compresions, then I tell them to get the aed ready and for the other one to ventilate. The person putting the aed on PUT THE PADS RIGHT ON TOP OF EACH OTHER BECAUSE THE PICTURES TOLD HIM TO. And the other one is trying to ventilate the patient while I am doing compressions at around 30 breaths per minute. Patient died, I got an A my partners failed. Long story short, some people just can't handle pressure. Some people just shouldn't be in EMS, same goes for the kid that puked during the birthing video.

/rant

[downshift_me]

But in a facility like this, I'm sure they'd have the little air bag and gas mask to not have to go mouth to mouth, right? Or the oxygen, I mean come on, old people everywhere. The only thing they carry around more often than hard candy is oxygen tanks.

Ambu bags are generally not in a nursing facility and if she was solo the ambu bag would NOT be a feasible option. Some people (myself) do carry around a mouthpiece to prevent actual "mouth-to-mouth." You also cannot just go haywire with oxygen either, because you will cause a vomit disaster with the likelihood of them aspirating into their lungs. Plus, not all masks have a oxygen port.

Compressions are the bare minimum you can do to help someone, but I am telling you right now if I did not perform as necessary or if there were an AED available and I didn't use it my boss would have my ass. Now, I will say things are ran quite a bit differently in a nursing facility and as stated their crash carts are not stocked very well. So, before you toss granny, gramps, mom, pop, etc into one you'd better make yourself clear on their policies and preparations in the event it happens.