# CPR when its not needed



## 74restore

Yesterday during my ride time we were dispatched to a 52 year old male, unresponsive and CPR in progress at a local psychiatrists office. He was in the middle of a mental health eval when he collapsed...

Turns out hes an alcoholic. He drinks a fifth of vodka daily and was quite inebriated when he collapsed.

We walked in the room to find a man doing pretty efficient CPR while the pateint moaned and yelled: "Oww....uugggghh...stop...it.....oww!" 

yes, our faithful bystander was doing CPR on an awake and breathing patient who was actively protesting it  . Needless to say we thanked the bystander and sent him on his way. Later in the ambulance our patient says "Why the hell does my chest feel like someone punched me?" The medic couldnt keep a straight face


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## Handsome Robb

It happens more often than you would think.

EMT/Security guards at the local casinos come to mind h34r:


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## Nervegas

DID YOU SEE THAT MECHANISM OF INJURY? I HOPE THEY DID SPINAL PRECAUTIONS!

:rofl::rofl::rofl:


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## silver

74restore said:


> Yesterday during my ride time we were dispatched to a 52 year old male, unresponsive and CPR in progress at a local *psychiatrists* office. He was in the middle of a mental health eval when he collapsed...
> 
> Turns out hes an alcoholic. He drinks a fifth of vodka daily and was quite inebriated when he collapsed.
> 
> We walked in the room to find a man doing pretty efficient CPR while the pateint moaned and yelled: "Oww....uugggghh...stop...it.....oww!"
> 
> yes, our faithful bystander was doing CPR on an awake and breathing patient who was actively protesting it  . Needless to say we thanked the bystander and sent him on his way. Later in the ambulance our patient says "Why the hell does my chest feel like someone punched me?" The medic couldnt keep a straight face



Was the psychiatrist present? Sure he or she deals with mental diseases, but he or she did go to medical school and most likely had some sort of internal medicine training in his or her residency.

I hope he or she could realize the patient was breathing...


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## ffemt8978

When I was teaching CPR classes, during the part covering when to stop CPR I always made sure to mention that you stop the second time your patient says, "OUCH!"


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## Martyn

Reminds me of one of my classmates from the other year. Two of them were/are volunteer firefighters. They were first on scene for an alleged cardiac arrest and one of them started to attempt CPR whilst patient was still seated in his car and without checking for a pulse first...:wacko:


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## mycrofft

"Sometimes they're not ALL the way dead"

(Photo courtesy of Florin EMS)


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## 74restore

yes, the psychiatrist was present. She simply stood in the corner and looked helpless while some random man did CPR on an awake patient. 

Why didnt she step in? We may never know the answer... 

It turns out that when the pt would "fall asleep," it would take a pretty firm sturnum rub to get him awake again. Maybe the CPR wasnt enough to get him awake at first... i dont know.


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## Emergency Laughter

I had a similar call while covering a marathon. A couple of guys started two-man cpr on a runner who fell. strangest damn thing to see.


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## phideux

Had one once at a local Holy Roller church. This place actually has a "nurse" on duty during the services. This "nurse" is about 70yrs old, and wears a nifty 1950s style nurse costume, complete with the dress, stockings, little cardboard hat and everything.  A sight to behold.
She had a 400lb girl have too many "praise Jesuses" or something and pass out. When we got there she was still pounding on that big girls chest, conscious and breathing. Broke 3 ribs.


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## Commonsavage

*How many psychiatrists does it take to perform CPR?*

I still need a punch line


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## Martyn

phideux said:


> Had one once at a local Holy Roller church. This place actually has a "nurse" on duty during the services. This "nurse" is about 70yrs old, and wears a nifty 1950s style nurse costume, complete with the dress, stockings, little cardboard hat and everything.  A sight to behold.
> 
> 
> 
> 
> 
> 
> I am deeply traumatised now. One of our crews got called back in to a dialysis center after leaving with their patient. Another pt in the center had gone into cardiac arrest. My colleauge said the center staff were doing compressions at about 80 per min at a depth of about 1/4". The person using the BVM didn't have a good seal and the chest wasn't rising at all. My two colleagues jumped into the rescue until an ALS truck got there. It's not just 'unnecessary' CPR but inadequate CPR as well.
Click to expand...


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## Emergency Laughter

*Great compressions dude!*

I broke up a cpr in progress / assault while covering the Honolulu Marathon years ago. A runner had gone down on his knees and was holding his chest so two good sams pounced on him.  
We rolled up a few minutes into it. Spit flying all over as the guy at the head tried to keep the runners head still and force air into him...it was pretty funny.


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## Emergency Laughter

How many psychiatrists does it take to do CPR?


Commonsavage said:


> I still need a punch line



Would you like to tell us how you feel about not having a punch line yet? 

When did you first realize that you didn't have a punch line? How did you feel then?


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## Altered Mental Status

What,in your own words, did not having a punch line feel like? On a scale of 1-10, 1 being the least bothersome and 10 being the most aggravating thing in your life, where does this incident of not having a punchline rate? Point to the place from where the punchline is missing. Is that the only spot?


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## Martyn

Altered Mental Status said:


> What,in your own words, did not having a punch line feel like? On a scale of 1-10, 1 being the least bothersome and 10 being the most aggravating thing in your life, where does this incident of not having a punchline rate? Point to the place from where the punchline is missing. Is that the only spot?


 You forgot..does it radiate anywhere? What type of pain is it? Stabbing? Sharp? Dull?   :rofl:


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## Chris07

ffemt8978 said:


> When I was teaching CPR classes, during the part covering when to stop CPR I always made sure to mention that you stop the *second* time your patient says, "OUCH!"


In case they were kidding the first time? :rofl:



silver said:


> Was the psychiatrist present? Sure he or she deals with mental diseases, but he or she did go to medical school and most likely had some sort of internal medicine training in his or her residency.
> 
> I hope he or she could realize the patient was breathing...


In teaching CPR I've come to realize the MD/DO after someone's name does not automatically qualify them as proficient CPR providers. It's scary but I've taught a physician who struggled with CPR. I've had a co-instructor tell me that he had an entire argument with a surgeon over why he needed to know CPR...after all he did have a nurse to do it for him! :glare:


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## Veneficus

Chris07 said:


> I've had a co-instructor tell me that he had an entire argument with a surgeon over why he needed to know CPR...after all he did have a nurse to do it for him! :glare:



ok, so what was the response?


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## Chris07

Veneficus said:


> ok, so what was the response?


The response included the generic "You can't always guarantee that someone else will be able to do CPR when crap happens". Also I believe he mentioned that CPR is amongst the most basic of interventions a physician should be able to deliver. It's required for a reason. ALS cannot be done without BLS.

In the end the surgeon just appeared to be inconvenienced by the fact that he had to sit in a 3 hour class rather than being convinced that CPR was not worth knowing.


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## EMSpursuit

Probably not common I would think...usually the Docs are not doing the CPR so they can ask questions, Order drugs, order tests, and figure out the plan.  I think CPR would take away from the concentration...also there are usually Lots and lots of people in the hospital to take turns on the CPR.  Funny they couldn't do it correctly none the less


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## Milla3P

Had a partner at an IFT co tell me he worked a code at his BLS university service and "We couldn't get the OPA in because of the rigor"


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## Meursault

Martyn said:


> I am deeply traumatised now. One of our crews got called back in to a dialysis center after leaving with their patient. Another pt in the center had gone into cardiac arrest. My colleauge said the center staff were doing compressions at about 80 per min at a depth of about 1/4". The person using the BVM didn't have a good seal and the chest wasn't rising at all. My two colleagues jumped into the rescue until an ALS truck got there. It's not just 'unnecessary' CPR but inadequate CPR as well.



Hey, at least they were trying. Last arrest I had, the medics had to shoo away one of the dialysis techs, who was trying to get the NIBP to work on the corpse.


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## jjesusfreak01

Chris07 said:


> In case they were kidding the first time? :rofl:
> 
> 
> In teaching CPR I've come to realize the MD/DO after someone's name does not automatically qualify them as proficient CPR providers. It's scary but I've taught a physician who struggled with CPR. I've had a co-instructor tell me that he had an entire argument with a surgeon over why he needed to know CPR...after all he did have a nurse to do it for him! :glare:



Tell them they should know how to do good CPR so they can tell when the nurses are doing it wrong


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## Handsome Robb

Chris07 said:


> In teaching CPR I've come to realize the MD/DO after someone's name does not automatically qualify them as proficient CPR providers. It's scary but I've taught a physician who struggled with CPR. I've had a co-instructor tell me that he had an entire argument with a surgeon over why he needed to know CPR...after all he did have a nurse to do it for him! :glare:



I've actually seen a trauma surgeon do CPR during my clinical hours. Needless to say she started doing it and I jumped in and offered to take over and she was more than happy to let me but she got a solid round in. 

Then again, after she called it she gave me the "good job" pat on the head and speech then told me that was the first time she'd done it in years and was glad that I was right there and willing to jump in.


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## OzAmbo

Chris07 said:


> It's required for a reason. ALS cannot be done without BLS.


ALS absolutely can be done without BLS

it doesn't achieve anything though


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## saskgirl

MrConspiracy said:


> Hey, at least they were trying. Last arrest I had, the medics had to shoo away one of the dialysis techs, who was trying to get the NIBP to work on the corpse.



Sadly I've had a couple RNs at our local rural hospital do the same thing... "we can't get a BP on this guy!!" "you don't say..."


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## Akulahawk

saskgirl said:


> Sadly I've had a couple RNs at our local rural hospital do the same thing... "we can't get a BP on this guy!!" "you don't say..."



Apparently they didn't listen to this guy:








:rofl:


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## mycrofft

*There's rigor, and rigor...*

"Can't get OPA in due to rigor". Maybe it was trismus?

If you've read my posts you know I think CPR is started inappropriately fairly frequently, and now with new guidelines even more so. This will lead to more "saves" being reported, but it will also hopefully scoop up the fraction of patients who would have expired while someone was trying to find a pulse.
I put my classes through two minutes of CPR. At about forty-five seconds I have to sound the cadence because they are dragging. At one minute I'm urging them on. Some are go-getters and can do it that long, but nearly everyone tends to drag it a little. And NO ONE wants to count out loud.


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## NJN

mycrofft said:


> And NO ONE wants to count out loud.



I get that a lot too when I teach, now my policy is if you don't count out loud, don't count on getting a card.


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## 74restore

I also teach CPR primarily to college students who were "voluntold" to be there, whether by there parents, or fraternity/sorority... 

You can imagine the seriousness they put into learning in this class. We force them to verbalize "Checking the scene, scene is safe, etc" and we also make them count out loud. We make sure they are very aware that we're not afraid to fail them


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## socalmedic

just two days ago I rolled up on scene to find bystander one (6'2" 220lbs) doing textbook compressions on a victim lying in the middle of the street. as soon as we put the amblam in park bystander two said "dude, you can stop now the paramedics are here". not three seconds pass before the "victim" is sitting up in the street telling us that his chest hurt. i then get ready to thank the bystander for "helping" when the victim passes out again and is not breathing...

lesson learned, chest compressions is enough of a stimuli to wake a heroin OD.


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## mycrofft

HAHAHAHA!!:rofl:


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## emt584841

I had something like that...

PD was dispatched to make a mandatory arrest on someone whos assaulted his gf. It just so happened that it was the first week for 6 new officers. 2 cars were dispatched both with 1 rookie each and about 2 minuets in the dispatcher asks for an update one of the officers gets on the radio screaming "send more units need back up on a rush". Sgt pulls up a few minuets later and says "headquarters start EMS it appears they are doing CPR". I get there and they are no longer doing CPR. The patient is on a long board and screaming "my chest". Turns out that the patient (about 300 lbs) didn't take kindly to the officers trying to arrest him so he fought the cops and eventually got knocked out. The officers assumed he was in arrest and started CPR. Oh well.


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## dacrowley

Chris07 said:


> I've had a co-instructor tell me that he had an entire argument with a surgeon over why he needed to know CPR...after all he did have a nurse to do it for him! :glare:



Just ask him if he'd have a nurse to do it for him at home if his wife or kids collapsed.


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## NHemt1

Its something that happens but shouldnt, I got called to the cardiac arresst at a local nursing home. When we arrived we found a fully awake and breathing man with a NRB on and a fully automatic defib on his chest...With a nervous face he looks at me as if the nurse is about to kill him...needless to say I pulled the pads off real quick..:blink:


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## lsmft

mycrofft said:


> I put my classes through two minutes of CPR. At about forty-five seconds I have to sound the cadence because they are dragging. At one minute I'm urging them on. Some are go-getters and can do it that long, but nearly everyone tends to drag it a little. And NO ONE wants to count out loud.



Only two minutes!? Man, in my class we had to do 5 minutes solo, then another ten minutes as a tag team. It sucked, but I guess I do feel prepared to actually give CPR.

No one ever wants to count though.


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## CMHills

lsmft said:


> Only two minutes!? Man, in my class we had to do 5 minutes solo, then another ten minutes as a tag team. It sucked, but I guess I do feel prepared to actually give CPR.
> 
> No one ever wants to count though.



In my class we had to do twenty minutes, rotating between three people and occasionally going to two-rescuer.

Nowadays when I teach, I just put on "Stayin' Alive" or "Another One Bites the Dust" (depending on the crowd) and tell them to keep pace with the beat. After a few minutes of that I shut the music off and let them go on their own.

And I tell people that if I can't hear them count from across the room, I can't know if they have the ratio right, so they may or may not get a card.


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## emtnc

Wow..just think, here in NC the governor just passed a law that all High School students must take/pass a CPR course before graduating.  Hmm, good or bad???


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## lsmft

emtnc said:


> Wow..just think, here in NC the governor just passed a law that all High School students must take/pass a CPR course before graduating.  Hmm, good or bad???



Sounds like a good idea to me. Should probably be taught in the health class most high schools have. Hopefully the worst thing that could happen is they give inadequate compression...

Although, if they're trying to teach them BLS or whatever, hyperventilating, or blowing into the stomach might actually do some harm.


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## shiroun

emtnc said:


> Wow..just think, here in NC the governor just passed a law that all High School students must take/pass a CPR course before graduating.  Hmm, good or bad???



Atleast NC did SOMETHING right. Not to get into politics here but that law prohibiting gay marriage is absolutely whack.

Also VERY good. When I was in HS we had a kid get an MI in the middle of the lunch room, and it was the day after i'd gotten my CPR cert. I walked in to see about 300 kids just looking at him all concerned, saying "call 911! hurry!" and other bull:censored::censored::censored::censored:.

MAYBE if we had CPR cert'd kids, it'd be better. I like that idea.


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## Swimfinn




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## Swimfinn

all i could think of reading these stories


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## onabemr

*waves, first-posting*

I teach CPR regularly up here in Canada and apparently I'm much meaner than some of you, heh. I make my students do way, way more than 2-5 minutes of CPR...


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## WedoAnnourn

I am a retired OR nurse an I gotta agree with THern...you have GOT to understand there are worse ways to go than cardiac arrest. During SHTF, If I have any direct intel on the previous health of the patient and they had diabetes, TB, COPD or if they have massive blood loss are septic or if they are above 75 years, I would need a STRONG reason to start CPR. To the untrained this may seem cruel, to medical professionals its called triage. If at ALL possible, I would make that pt. and their family as comfortable as possible in their final moments together. I would expect/appreciate the EXACT same treatment of myself and family.


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## Sparky79

WedoAnnourn said:


> I am a retired OR nurse an I gotta agree with THern...you have GOT to understand there are worse ways to go than cardiac arrest. During SHTF, If I have any direct intel on the previous health of the patient and they had diabetes, TB, COPD or if they have massive blood loss are septic or if they are above 75 years, I would need a STRONG reason to start CPR. To the untrained this may seem cruel, to medical professionals its called triage. If at ALL possible, I would make that pt. and their family as comfortable as possible in their final moments together. I would expect/appreciate the EXACT same treatment of myself and family.



It sounds like malpractice/negligence to me. 

It's not your job to determine the value of your patients life. Your job is to treat your patients according to the accepted professional practices. Whether you feel they are worth saving or not, if your patient does not have a DNR withholding possible life saving procedures/interventions is criminal, IMO.


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## Handsome Robb

I agree with wedo but I also agree with sparky.

Yes, we do triage, is the elderly septic patient or advanced stage cancer patient (just examples) and their family going to appreciate you saving them so they can live on life support for a few more days or weeks? Maybe yes, maybe no. 

At the same time, like sparky said, we're bound by our duty to act while at work. No valid DNR resuscitation must be started. We don't get to play god. Hell even physicians don't do that.

 f the family requests we do not attempt to resuscitate the patient I have zero problems doing compressions only CPR and calling for termination orders while explaining to the family why I'm doing things the way I am. Hell worst comes to worst (family gets aggressive or violent with you) don't do anything, call a doc and explain the situation if its safe to do so or just leave, call for pd and call a doc as well.

I've run into it a few times and have yet to have a family be anything but appreciative and thankful for the way I cared for their loved on and respected their wishes.


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## mycrofft

WedoAnnourn said:


> I am a retired OR nurse an I gotta agree with THern...you have GOT to understand there are worse ways to go than cardiac arrest. During SHTF, If I have any direct intel on the previous health of the patient and they had diabetes, TB, COPD or if they have massive blood loss are septic or if they are above 75 years, I would need a STRONG reason to start CPR. To the untrained this may seem cruel, to medical professionals its called triage. If at ALL possible, I would make that pt. and their family as comfortable as possible in their final moments together. I would expect/appreciate the EXACT same treatment of myself and family.



I'm trained and that, without further explaination, is manslaughter. In fact, since it appeared here before it was done, 1st degree. 

Denying basic care is not the same as not-starting on a decapitation...deucedly hard to get a mask seal on those....h34r:


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## DeepFreeze

Sparky79 said:


> It's not your job to determine the value of your patients life. Your job is to treat your patients according to the accepted professional practices. Whether you feel they are worth saving or not, if your patient does not have a DNR withholding possible life saving procedures/interventions is criminal, IMO.



I couldn't say it better myself sparky. Unless the pt has a DNR, or lividity or decapitated, I do what I've been trained to do. Sounds like someone is burnt out if they can't make that rational decision.


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## TheLocalMedic

I decide if you live or die! Mwahahahahaha!


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## samiam

WedoAnnourn said:


> I am a retired OR nurse an I gotta agree with THern...you have GOT to understand there are worse ways to go than cardiac arrest. During SHTF, If I have any direct intel on the previous health of the patient and they had diabetes, TB, COPD or if they have massive blood loss are septic or if they are above 75 years, I would need a STRONG reason to start CPR. To the untrained this may seem cruel, to medical professionals its called triage. If at ALL possible, I would make that pt. and their family as comfortable as possible in their final moments together. I would expect/appreciate the EXACT same treatment of myself and family.


 

This is absolutely inappropriate and is asking for a murder trial. You have a ethical and legal obligation to a patient unless there is a DNR or other document stating that lifesaving interventions are not wanted. What you are saying is that if my 78 year old grandfather took to much insulin one day and went into cardiac arrest you would do nothing for him? This is just un-ethical and ridiculous.  I know plenty of people over 75 that are active and lively and would do just fine bouncing back from a MI or other condition that could be easily intervened upon and fixed. You have no right to play god and make these decisions for the patient.


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## Emtsgv

Emergency Laughter said:


> I had a similar call while covering a marathon. A couple of guys started two-man cpr on a runner who fell. strangest damn thing to see.



this sounds like some EMT's i know from my old class

"im waiting for someone to drop AND IM DOING CPR"

rofl gotta love it


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## NBFFD2433

Robb said:


> It happens more often than you would think.
> 
> EMT/Security guards at the local casinos come to mind h34r:



I would have to agree. At least the bystander knows CPR. Most don't.


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