Boosting confidence through knowledge.

Call Us! (800) 881-CPR1

Advance Directives and DNR Orders

Advance Directives and DNR Orders

Despite what you see on TV, more often than not, CPR does not bring people back from the dead.  In fact, a recent study showed that the percent of people who “come back” with CPR is less than 5%.

What’s important to remember is that CPR doesn’t fix or reverse underlying problems.  For example, if a person’s neck is broken during a car accident and their heart stops, without oxygen, their brain dies.  Performing CPR after that simply won’t work.  However, that doesn’t mean we shouldn’t try; the decision to stop CPR shouldn’t be a decision taken lightly and should be done only by medical professionals.  There are also legal and ethical implications too, as I’m sure you could have guessed.

What happens when you call 911?

When the paramedics respond for a person who has no pulse, they start CPR, unless the person has Do Not Resuscitate (DNR) paperwork.  Now, this varies with local laws and individual medical directors, but this is generally the case.

That sounds good, right?

For healthy people who fall ill, immediate and effective CPR has a greater chance of being effective.  But what about unhealthy people where dying is expected?  What about previously healthy people who are now gravely ill?

Generally, the first-responders are obligated to start CPR, even if the person is not expected to live.  Not only is CPR is traumatic to the body, it’s important to know that even if the person’s heart begins beating again, it does not necessarily mean that they will begin breathing on their own—or that they will even wake up.  CPR on these people may cause them to go into a vegetative state in which the have no higher brain function and cannot communicate or understand what’s happening.

What people need to understand is that, in most situations, they have a choice of whether or not to have CPR and/or other life-saving measures performed.  These decisions, known as Advanced Directives, need to be made before the person is in that situation (obviously) and should be communicated to family members.  The paperwork should be always available to show to medical professionals.

It’s a personal decision, and one which should not be taken lightly.  However, many medical professionals can recall more than a few times where they were forced by protocol to begin CPR on a person for whom it was inappropriate.  In those situations, the family is given false hope that their loved one may “come back to life,” and instead of allowing the person to remain as they were, they have their ribs crushed and tubes shoved down their throats.  In those situations, the person and the family may have been better served had the CPR not occurred because of an Advance Directive or DNR.

Final Thoughts

Knowing that CPR may not be effective (or even appropriate) for a lot of situations, it’s important for the general public to be more educated on their options.

However, I have personally “saved” a person with CPR.  I know without a doubt that because of immediate family member CPR, followed by CPR from me and my partner, with life-saving drugs, along with defibrillation, and a team of doctors and nurses at the hospital, we brought a person back to life who was able to walk out of the hospital with no disability or brain damage.

That is why we do CPR.  It doesn’t matter that it’s not effective on most people; to that one person, it meant everything.

Take a class and educate yourself.  Without bystander or family-initiated CPR, the person may not have a chance.

Texas Advance Directive Info

This blog post was inspired by this article.

Remember, this is a blog meant to start a conversation; don’t make medical decisions based on this.  Talk to your doctor and/or your lawyer when making these types of decisions.

Filed Under: CPR
AHA 2015 CPR Algorithm Guidelines

AHA 2015 CPR Algorithm Guidelines

Follow your local protocols.  This is a blog and not intended to serve as medical advice. Updated (2015) CPR Recommendations The American Heart Association, in an extensive evidence evaluation process with the International Liaison Committee on Resuscitation (ILCOR), has released updated algorithm guidelines recommendations for CPR.  I recommend that you read their articles. To summarize… Continue Reading

Rhythmic Compressions Saves Lives

Rhythmic Compressions Saves Lives

According the American Heart Association, in a recent interview with NPR, ensuring that CPR is performed at the right rate increases CPR effectiveness by 22%. The study showed that CPR compressions at a rate of 100-120 beats per minute were most effective, which is in line with the AHA’s 2010 guidelines of “at least 100 compressions… Continue Reading

Medical Information Sheet

Medical Information Sheet

If you’re in an accident or are having a medical emergency, you want the paramedics and doctors to have as much information as possible, right? As a paramedic, I can’t tell you how many times I’ve arrived to a patient’s house and have absolutely no idea what kind of medications they take or what chronic… Continue Reading

What Happens When You Call 911?

What Happens When You Call 911?

Need Police, Fire, or EMS?  In the USA, we know to call 911–but do you know what actually happens when you dial that emergency number? Local 911 systems vary.  While some have advanced technology, like text-messaging capabilities and GPS tracking of emergency vehicles, others are less fortunate.  It’s important to understand the basics though, so… Continue Reading