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(LA Times)   911 dispatcher "Is there anybody that's willing to help this lady and not let her die?" Nurse at senior living center "Um, not at this time"   (latimesblogs.latimes.com) divider line 438
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23486 clicks; posted to Main » on 03 Mar 2013 at 9:13 PM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-03-03 11:56:25 PM

ArcadianRefugee: ZeroCorpse: People don't become doctors or nurses, or join the medical profession at all these day because they want to help people and save lives. These days, they do it because they want lots of money.

It's a disgrace that we even use the words "nurse" and "doctor" to describe these greedy animals. They bring dishonor to the words.

Pfft. To the people of the Gamma Forests, the word "doctor" means "mighty warrior".


*nerd-squeal*

/whovian
 
2013-03-03 11:57:10 PM
Not commenting on whether the nurse should have performed CPR (which I believe she should have) but on some of the suggestions and opinions stated which are truly baffling...

I have seen the statistic of 2% of people recovering fully after CPR is performed....and the American Heart Association states that 92,000 people were saved by CPR last year....so if both statistics are correct, or even close to correct, that means between 1500-2000 people were not only saved but were able to fully recover from whatever caused CPR to be necessary....

That's a lot of people surviving for CPR to be called "cruel, torturous, and ineffective"

My 2 cents
 
2013-03-03 11:57:56 PM

djh0101010: AJisaff: CPR on a living patient is a good way to kill them. The lady was breathing. CPR is the wrong treatment. Turn up the O2, maybe even bag her, but the dispatcher was wrong telling the nurse to do CPR on a living patient.

i am sorry, but where the hell did you get trained?? CPR is exactly what is performed on a choking casualty, and doesn't kill them. i agree that CPR on an elderly patient will probably not have a positive outcome, but the lazy biatch didn't even try. Most likely she was going through agonal respirations, not proper breaths. i posted this already, and it seems pretty self explanatory even in laymans' terms...

You seem to be confusing the Heimlich Maneuver with cardiac compressions.  Totally different mechanism, different action, different part of the body, and for a different reason.  If you're doing CPR on a choking patient, you missed the "airway" part and jumped all the way up to "circulation".


um.. no, actually... if a choking patient becomes unconscious, we go to chest compressions.  and the heimlich manoever on it's own has been outdated for about two years now.  we do 5 back blows to relieve the laryngospasm, then 5 abdominal thrusts, until it is cleared, or they become unconscious...  at which point you start chest compressions, check the airway, attempt vents, and clear obstructions if found.
comressions and vents ARE CPR.
 
2013-03-03 11:58:57 PM
The most effective method is to perform CPR for a while, then have someone pull you off the patient as you scream and cry.  After a few seconds the patient will spontaneously take a huge breath, will be mostly recovered within an hour or two.

Also, why don't most nurses carry those Make Heart Go Now syringes with them at all times?  Just slam those suckers directly nto the heart and, bam, alive and kicking.
 
2013-03-03 11:59:12 PM

BuckTurgidson: Cyno01: Patient was breathing, CPR should not have been performed, 911 dispatchers are not medical personnel, non story.

And yeah, from my meager training, CPR on the elderly is not always the best idea, even on a healthy person if you do CPR right youre likely to break a rib or two. One thing i explicitly remember from training is to make sure youre doing compressions high enough on the patient, or youre likely to break the xiphoid process and cause internal bleeding. I remember that so well because the instructor kept saying regarding the possible internal hemorrhaging that it would "bleed like stink" and that was really funny for some reason.

CPR is not the panacea you see on television.

What about the magical defibberallator machine? That ALWAYS works, whether it's heart attack or poison or drowning or dyspepsia or whatever.


And it gives you an orgasm every time.
 
2013-03-04 12:02:48 AM

AJisaff: djh0101010: AJisaff: CPR on a living patient is a good way to kill them. The lady was breathing. CPR is the wrong treatment. Turn up the O2, maybe even bag her, but the dispatcher was wrong telling the nurse to do CPR on a living patient.

i am sorry, but where the hell did you get trained?? CPR is exactly what is performed on a choking casualty, and doesn't kill them. i agree that CPR on an elderly patient will probably not have a positive outcome, but the lazy biatch didn't even try. Most likely she was going through agonal respirations, not proper breaths. i posted this already, and it seems pretty self explanatory even in laymans' terms...

You seem to be confusing the Heimlich Maneuver with cardiac compressions.  Totally different mechanism, different action, different part of the body, and for a different reason.  If you're doing CPR on a choking patient, you missed the "airway" part and jumped all the way up to "circulation".

um.. no, actually... if a choking patient becomes unconscious, we go to chest compressions.  and the heimlich manoever on it's own has been outdated for about two years now.  we do 5 back blows to relieve the laryngospasm, then 5 abdominal thrusts, until it is cleared, or they become unconscious...  at which point you start chest compressions, check the airway, attempt vents, and clear obstructions if found.
comressions and vents ARE CPR.


Breaths, thrusts, and back until something else is needed.  I sure as hell hope you guys are not doing compressions on someone with a pulse.  Unconscious != pulseless.
 
2013-03-04 12:05:17 AM
Only in Minnesota and Vermont are you required to perform cpr if you're certified. If she was breathing then she needed her mouth cleared and a jaw thrust procedure to open the airway.
 
2013-03-04 12:06:28 AM
RULES ARE RULES! WAARGAARRBLE
 
2013-03-04 12:06:59 AM
I just listened to the recording, that dispatcher really had no clue what was going on.

I've been to homes like this.  You have the residents(elderly) and workers there, that's pretty much it.  If the workers can't do it(CPR) you sure as hell aren't going to get that 90 year old guy eating lunch to do it.  Gimme a break!

If there by chance was a family member having lunch there with her grandma, imagine the reaction if the nurse hands the phone over to her saying "Here, they're going to talk you through doing CPR on this woman".   Haha, no.
 
2013-03-04 12:07:55 AM

BafflerMeal: AJisaff: djh0101010: AJisaff: CPR on a living patient is a good way to kill them. The lady was breathing. CPR is the wrong treatment. Turn up the O2, maybe even bag her, but the dispatcher was wrong telling the nurse to do CPR on a living patient.

i am sorry, but where the hell did you get trained?? CPR is exactly what is performed on a choking casualty, and doesn't kill them. i agree that CPR on an elderly patient will probably not have a positive outcome, but the lazy biatch didn't even try. Most likely she was going through agonal respirations, not proper breaths. i posted this already, and it seems pretty self explanatory even in laymans' terms...

You seem to be confusing the Heimlich Maneuver with cardiac compressions.  Totally different mechanism, different action, different part of the body, and for a different reason.  If you're doing CPR on a choking patient, you missed the "airway" part and jumped all the way up to "circulation".

um.. no, actually... if a choking patient becomes unconscious, we go to chest compressions.  and the heimlich manoever on it's own has been outdated for about two years now.  we do 5 back blows to relieve the laryngospasm, then 5 abdominal thrusts, until it is cleared, or they become unconscious...  at which point you start chest compressions, check the airway, attempt vents, and clear obstructions if found.
comressions and vents ARE CPR.

Breaths, thrusts, and back until something else is needed.  I sure as hell hope you guys are not doing compressions on someone with a pulse.  Unconscious != pulseless.


No no, didn't you see all the "medics" up there saying you should be doing CPR for choking victims (and/or 87 year old ladies)? Don't be a fool, CPR is appropriate for everyone, and even laypeople should give it a shot.
 
2013-03-04 12:08:34 AM

ignacio: I don't know if it was the right choice, but I'm inclined to believe the trained nurse over the news here.


I'd just like to point out that we're currently arguing over whether it's the nurse, the journalist, or the 911 dispatcher who is an utter failure at their basic job functions. What the hell kind of society do we live in where this isn't an insane argument? I mean, just think about it for a moment: we really do live in a world where we don't find it unremarkable that any person could suck at their job so badly, even the people whose job it is to tell us that others suck at their jobs.
 
2013-03-04 12:09:07 AM

Birnone: If there by chance was a family member having lunch there with her grandma, imagine the reaction if the nurse hands the phone over to her saying "Here, they're going to talk you through doing CPR on this woman". Haha, no.


Because THAT was "Plan A" in this whole thing.
 
2013-03-04 12:12:12 AM

flamingboard: RULES ARE RULES! WAARGAARRBLE


Given the comments here, I half expect someone to hunt the nurse down and light her up.
 
2013-03-04 12:12:25 AM

James F. Campbell: FTA: Bayless' daughter told KGET that she was a nurse and was satisfied with her mother's care at Glenwood Gardens, the station reported.

IIIInteresting.


I read that part, too. If the daughter doesn't have an issue with what happened, then my outrage meter dispersed. I also have a feeling that there is some other dynamic to this whole situation that will complicate a blind outrage. Maybe the woman had some communicable disease. Maybe she had vomited and/or some other bodily fluid was all over her mouth and it would've created a hazard situation to perform assisted breathing exercises.

As also stated upthread, the woman was breathing, just badly. She had a pulse. Performing CPR would not be appropriate.. CPR nowadays is about chest compressions. You do not do the breathing part of it. It sounds to me like the nurse knew that, made an education decision that CPR wouldn't help and called 911 to get the woman the appropriate help. If that is true, I do not see where the rage should be.

/on Ambien so I may make no sense
 
2013-03-04 12:14:51 AM

silverjets: I'm guessing that the "nurse" in the facility really isn't a nurse.


I came to point this out. My mother in law just moved into 'assisted' living and spent two weeks in a full nursing home. They both have one nurse on duty (RN).
Patients and family refer to the rest of the staff as nurses, but I think they are 'just' called Care Staff.
 
2013-03-04 12:15:14 AM

octopied: Perhaps the patients there have DNR orders.

If you don't know what that is, it's for people who are viewed as so close to death that they have orders for  no CPR to be performed, as they want to die "naturally".


Perhaps that was covered in the article.

If you don't know what that is, it's the information contained on the webpage that is linked to the left of the headline, and often contains details that are pertinent to understanding the headline.
 
2013-03-04 12:15:25 AM
Wow, lots of folks just gleefully missing the point...perform CPR, don't perform CPR, whatever. The appalling part of the story is the way the nurse wanted to pass the buck and "not make that call". Listen dipshiat if you did not want to have to make calls in life or death situations THEN DON'T BECOME A NURSE!
 
2013-03-04 12:17:00 AM

BafflerMeal: AJisaff: djh0101010: AJisaff: CPR on a living patient is a good way to kill them. The lady was breathing. CPR is the wrong treatment. Turn up the O2, maybe even bag her, but the dispatcher was wrong telling the nurse to do CPR on a living patient.

i am sorry, but where the hell did you get trained?? CPR is exactly what is performed on a choking casualty, and doesn't kill them. i agree that CPR on an elderly patient will probably not have a positive outcome, but the lazy biatch didn't even try. Most likely she was going through agonal respirations, not proper breaths. i posted this already, and it seems pretty self explanatory even in laymans' terms...

You seem to be confusing the Heimlich Maneuver with cardiac compressions.  Totally different mechanism, different action, different part of the body, and for a different reason.  If you're doing CPR on a choking patient, you missed the "airway" part and jumped all the way up to "circulation".

um.. no, actually... if a choking patient becomes unconscious, we go to chest compressions.  and the heimlich manoever on it's own has been outdated for about two years now.  we do 5 back blows to relieve the laryngospasm, then 5 abdominal thrusts, until it is cleared, or they become unconscious...  at which point you start chest compressions, check the airway, attempt vents, and clear obstructions if found.
comressions and vents ARE CPR.

Breaths, thrusts, and back until something else is needed.  I sure as hell hope you guys are not doing compressions on someone with a pulse.


 Unconscious != pulseless.???


hm.  i have been teaching this for 7 years now and the protocols have not changed in that regard, anyway.  chest compressions are called for in the event of a choking collapse, both to attempt to remove the object, and circulate blood.

maybe this article will make it clearer.
http://www.royonrescue.com/2013/01/question-answered-regarding-aggres i ve-chest-compressions-and-unconscious-choking-patient/">http://www.ro yonrescue.com/2013/01/question-answered-regarding-aggresi ve-chest-compressions-and-unconscious-choking-patient/
 
2013-03-04 12:19:49 AM
The nurse in question may not actually be any kind of nurse at all.  She may be a CNA or what they call a DCS (direct care staff) which have no credentials beyond in-facility training and first aid/cpr.  The home I worked at for disabled children was completely staffed by DCS with a nurse that oversaw several homes and stopped by maybe once a week to look paperwork over.  But you could reach her by phone if medical issues arose...

Of course, we also had a strict policy of performing CPR immediately on any patient that stopped breathing or experienced agonal breathing, and we did not allow DNR orders to be filed.  If the parents wanted DNR orders, they were to file them at the hospital.
 
2013-03-04 12:20:36 AM

Owangotang: Wow, lots of folks just gleefully missing the point...perform CPR, don't perform CPR, whatever. The appalling part of the story is the way the nurse wanted to pass the buck and "not make that call". Listen dipshiat if you did not want to have to make calls in life or death situations THEN DON'T BECOME A NURSE!


I disagree.  If I'm a nurse and take a job dispensing meds or whatever to seniors at a place that specifically does not allow me to do CPR on them, then I can say I didn't sign up for that(to make that call).

If she had a job where CPR might be a thing she'd need to do, then yes I think she should have done it.  But this is not that kind of job.
 
2013-03-04 12:21:31 AM

herdgirl72: Unbelievable. I don't care what my workplace policy is. If that lady was Full Code and not DNR, I'm a nurse, i should do CPR. I'd rather lose my job than my license.


As a camera operator doing legal video I had an old guy give out on me.
Everyone had left, the lawyers and the court reporter his wife were all gone.
I'm coiling cable and I went for the mic and realized he was blue.
Vigorously called the nurses station and it was pretty much a "Meh, he's a DNR so don't worry, we'll be right there"
I dragged the rest of the kit out the door and packed up in the parking lot.

It seemed painless and it seemed right.  He knew he wasn't getting out or getting better.  He just wanted justice to provide for his wife.  Keeping him going wasn't the best policy.
 
2013-03-04 12:22:55 AM
My father spent the last 6 months of his life in two separate nursing homes - one which showed little interest at all as he suffered from an accidental Fentanyl overdose, and another that showed little interest as he became disoriented from a near fatal UTI.  (Repeated infections did later help claim his life.)  I can't imagine the horrors people go through who DON'T have family visiting them every day.
 
2013-03-04 12:32:17 AM

Birnone: I wasn't aware that dispatchers could 'talk' you through CPR.  I thought people got certified in that, taking classes and such.


Paramedics get certified, and have special tools they can use too, but anyone can perform CPR. You don't need a certification.

Birnone: I'm guessing further information will show that the 87 year old resident had other issues that would have made it a moot point anyways. It's not like simply doing CPR saves everyone.


So, why bother then? Is that your point?
 
2013-03-04 12:36:35 AM

AJisaff: BafflerMeal: AJisaff: djh0101010: AJisaff: CPR on a living patient is a good way to kill them. The lady was breathing. CPR is the wrong treatment. Turn up the O2, maybe even bag her, but the dispatcher was wrong telling the nurse to do CPR on a living patient.

i am sorry, but where the hell did you get trained?? CPR is exactly what is performed on a choking casualty, and doesn't kill them. i agree that CPR on an elderly patient will probably not have a positive outcome, but the lazy biatch didn't even try. Most likely she was going through agonal respirations, not proper breaths. i posted this already, and it seems pretty self explanatory even in laymans' terms...

You seem to be confusing the Heimlich Maneuver with cardiac compressions.  Totally different mechanism, different action, different part of the body, and for a different reason.  If you're doing CPR on a choking patient, you missed the "airway" part and jumped all the way up to "circulation".

um.. no, actually... if a choking patient becomes unconscious, we go to chest compressions.  and the heimlich manoever on it's own has been outdated for about two years now.  we do 5 back blows to relieve the laryngospasm, then 5 abdominal thrusts, until it is cleared, or they become unconscious...  at which point you start chest compressions, check the airway, attempt vents, and clear obstructions if found.
comressions and vents ARE CPR.

Breaths, thrusts, and back until something else is needed.  I sure as hell hope you guys are not doing compressions on someone with a pulse.


 Unconscious != pulseless.???

hm.  i have been teaching this for 7 years now and the protocols have not changed in that regard, anyway.  chest compressions are called for in the event of a choking collapse, both to attempt to remove the object, and circulate blood.

maybe this article will make it clearer.
http://www.royonrescue.com/2013/01/question-answered-regarding-aggres i ve-chest-compressions-and-unconscious-choking-patient/">htt ...



Ah.  I see.  My involvement in the thread made me alter a few facts in my memory.  You're right regarding after a choking or presumed choking event.  In my head I responding to something that wasn't there.  I was thinking about the breathing and pulse != cpr argument.
 
2013-03-04 12:37:13 AM

Forecaster18: My father spent the last 6 months of his life in two separate nursing homes - one which showed little interest at all as he suffered from an accidental Fentanyl overdose, and another that showed little interest as he became disoriented from a near fatal UTI.  (Repeated infections did later help claim his life.)  I can't imagine the horrors people go through who DON'T have family visiting them every day.


My grandmother had some pains, and she didn't know why. It was kidney stones, but the doctor didn't do any testing for it. His words "she's old, pain's a part of that." We fired him that day. Got another doctor the next day, he treated her and she felt so much better. Not getting the treatment you want, fire the bums! If I had a parent or grandparent in the place in this article they would be out ASAP.
 
2013-03-04 12:38:49 AM

AverageAmericanGuy: I'm going to sound cold here, but the woman was in her late 80s. Sometimes its just a person's time to go.

The operator sounds like a spaz, from the way she's portrayed in the article. "It's a human being" Yes, and human beings die all the time. You can't be Superman and save everyone all the time.


So then, why even bother? That is your point?
 
2013-03-04 12:38:56 AM

The One True TheDavid: I'm waiting to see what BronyMedic says.


Me too. But my layperson thoughts on it (I have CPR certification but it's long expired) were ...I could see not doing chest compressions on someone in distress but still has a heartbeat who is elderly because you're going to pop a shiatload of ribs and potentially kill them. Assisted breathing however...I'd have done it. Especially since she did NOT have a DNR.

DNRs should be respected, though just through anecdotal accounts, it seems that the tendency is for it to be ignored and 'heroic' measures taken more often than someone is just left alone.

To my knowledge (and I could easily easily be wrong here) there's times where breathing alone is called for. I would think this would be one. Drowning is another. Other than that AFAIK, chest compress is most important (to the tune of Stayin' Alive).

And yeah, CPR usually fails. I don't know of anyone who's done it in an emergency situation where the person has survived (outside of a hospital or being an EMT). Everyone I know who has, the person died. Still...I'd rather try to help.

But when I took the class we were told repeatedly that chest compressions if done right, were gonna at a bare min. crack ribs. In someone injured, it could tear up their liver, puncture their lungs, etc. This shiat was hammered home in a 'be sure it's needed before you do it' way. In that you'd best be damned farking sure there's no heartbeat or respiration before you start cracking up their ribs, especially if they're old. We were also told (because the instructor was awesome) that odds were not good and if the person didn't make it...well, that was sadly the odds. Not to blame ourselves, better to help and try than do nothing. 5% chance is still a chance.

Anyhoo, looking forward to Brony and others who certainly know more than me on this shiat. :D

/has never done it except on a doll
/would like to keep it that way ideally
 
2013-03-04 12:39:24 AM

Birnone: Owangotang: Wow, lots of folks just gleefully missing the point...perform CPR, don't perform CPR, whatever. The appalling part of the story is the way the nurse wanted to pass the buck and "not make that call". Listen dipshiat if you did not want to have to make calls in life or death situations THEN DON'T BECOME A NURSE!

I disagree.  If I'm a nurse and take a job dispensing meds or whatever to seniors at a place that specifically does not allow me to do CPR on them, then I can say I didn't sign up for that(to make that call).

If she had a job where CPR might be a thing she'd need to do, then yes I think she should have done it.  But this is not that kind of job.


Re-read the statement by the director of the facility, he does not say that performing CPR is not allowed. He simply says that the policy is to call for emergency medical assistance and then stay with the individual. That means it was the nurse's call, whether she "signed up for" that or not. Being a nurse is a job where CPR just might be a thing you have to do, that is simple common sense.
 
2013-03-04 12:39:54 AM

James F. Campbell: FTA: Bayless' daughter told KGET that she was a nurse and was satisfied with her mother's care at Glenwood Gardens, the station reported.

IIIInteresting.


More moolah for her to inherit...
 
2013-03-04 12:45:23 AM

herdgirl72: Unbelievable. I don't care what my workplace policy is. If that lady was Full Code and not DNR, I'm a nurse, i should do CPR. I'd rather lose my job than my license.


I'm just some guy and if I saw this I'd like to think I'd jump in and at least try. I've taken a CPR class. If it didn't work, I don't think I'd stick around to answer questions, though.
 
2013-03-04 12:46:34 AM

Abacus9: Birnone: I wasn't aware that dispatchers could 'talk' you through CPR.  I thought people got certified in that, taking classes and such.

Paramedics get certified, and have special tools they can use too, but anyone can perform CPR. You don't need a certification.

Birnone: I'm guessing further information will show that the 87 year old resident had other issues that would have made it a moot point anyways. It's not like simply doing CPR saves everyone.

So, why bother then? Is that your point?


No, my point was just that outrage over the nurse not 'saving' her is misplaced if she couldn't be saved in the first place.

My evidence that she couldn't be saved in the first place is that she was 87 and needed CPR, two things that when taken together would indicate to me that this person is farked.   What evidence does anyone have that this woman could be saved?
 
2013-03-04 12:47:08 AM

Birnone: I wasn't aware that dispatchers could 'talk' you through CPR.  I thought people got certified in that, taking classes and such.

I'm guessing further information will show that the 87 year old resident had other issues that would have made it a moot point anyways.  It's not like simply doing CPR saves everyone.


They made CPR idiot proof. Anyone that can follow the command to "put your hands in the middle of the chest and push hard and fast" can do CPR
 
2013-03-04 12:49:11 AM
I did CPR on a guy and he lived. He was quite blue, but he had a pulse. I breathed into his mouth until the ambulance arrived. He returned to pink and breathing right as they showed up. The EMTs seemed almost kinda pissed off. Not sure why. Anyway, breaths only, no compressions.

I think the people who teach CPR have never used it to save a life so they have no idea what they're talking about. You can't hurt anyone by breathing in their mouth.
 
2013-03-04 12:49:43 AM

jakepowers: Birnone: I wasn't aware that dispatchers could 'talk' you through CPR.  I thought people got certified in that, taking classes and such.

I'm guessing further information will show that the 87 year old resident had other issues that would have made it a moot point anyways.  It's not like simply doing CPR saves everyone.

They made CPR idiot proof. Anyone that can follow the command to "put your hands in the middle of the chest and push hard and fast" can do CPR


Most people don't know how hard to push, nor how fast.
 
2013-03-04 12:50:34 AM

Acravius: Here is CPR: 30 compressions 2 breaths,
                      Repeat 5 times in approximately 2 minutes
                      Assess patient for 10 seconds, listening/looking/feeling for pulse, breath or rise/fall in chest.
                      If no change, resume CPR
                      If AED is available then hook up AED, (Turn On, listen to instructions)
                      Shock, as advised by AED
                      After 3 shocks maximum
                      Assess Patient, as before
                      If no change Resume CPR 5 cycles per 2 minutes, repeat until more qualified personelle come on the scene.
Good Samaritan Laws protect people who use reasonable actions in performing these duties, regardless of outcomes.

So yes it could be instructed over the phone, and still be covered by the Good Samaritan Law.


Actually, they don't recommend the breaths anymore. It's more important to get the heart going again than to waste time forcing useless CO2 into the lungs. Paramedics have a device they can use though that will force ambient air into the lungs, and if certified, are supposed to use it. Also, shocks won't do any good if the heart is completely stopped. For that you want epinephrine. Then maybe a shock.
 
2013-03-04 12:50:51 AM

Anastacya: As also stated upthread, the woman was breathing, just badly. She had a pulse. Performing CPR would not be appropriate..


I know it's been pointed out several times, but agonal respirations happen quite frequently with cardiac arrest, especially when the person is in v-fib.  If she was gasping and had no palpable pulse, then CPR is absolutely indicated.

The larger issue is the stupid policy of the facility to not perform CPR.  Yes, it probably would not have made a difference in the case of this 87 year old lady, but what if the 40 year old cook collapses in cardiac arrest?  These places are full of dumb liability driven policies, such as calling 911 whenever a resident falls, even if there are no injuries and the resident doesn't want to go to the hospital.
 
2013-03-04 12:51:21 AM

mccallcl: I did CPR on a guy and he lived. He was quite blue, but he had a pulse. I breathed into his mouth until the ambulance arrived. He returned to pink and breathing right as they showed up. The EMTs seemed almost kinda pissed off. Not sure why. Anyway, breaths only, no compressions.

I think the people who teach CPR have never used it to save a life so they have no idea what they're talking about. You can't hurt anyone by breathing in their mouth.


Comedy gold right here....
 
2013-03-04 12:52:05 AM

Yogimus: I am sure a breating 84 year old is much better off without a nurse slamming on her chest.  Besides, CPR works less than 1% of the time.


Citation needed.
 
2013-03-04 12:53:38 AM
lh4.googleusercontent.com
 
2013-03-04 12:55:41 AM

AJisaff: digitalrain: Acravius: Here is CPR: 30 compressions 2 breaths,
                      Repeat 5 times in approximately 2 minutes
                      Assess patient for 10 seconds, listening/looking/feeling for pulse, breath or rise/fall in chest.
                      If no change, resume CPR
                      If AED is available then hook up AED, (Turn On, listen to instructions)
                      Shock, as advised by AED
                      After 3 shocks maximum
                      Assess Patient, as before
                      If no change Resume CPR 5 cycles per 2 minutes, repeat until more qualified personelle come on the scene.
Good Samaritan Laws protect people who use reasonable actions in performing these duties, regardless of outcomes.

So yes it could be instructed over the phone, and still be covered by the Good Samaritan Law.

What happened to "one-one-thousand-two-one-thousand-three-one-thousand-four-one-thousan d-five-one-thousand-BREATHE" ?

it takes a minimum of 30 compressions to circulate blood through the body once.  sing staying alive under your breath and you will have the right speed.  1.6 compressions per second.  compression only cpr is fine for non-drowned adult casualties, but not in situations where they were already oxygen deprived.  aim high in the center of the chest, compress at least two inches, and allow the chest full recoil.

and yeah.  i teach it for a living.  i also teach health care provider levels, which is teaching nurses cpr.  i am horrified by this whole concept that a nurse would abrogate her duty like this.


Thanks for updating my CPR knowledge (seriously - thanks!)
 
2013-03-04 12:57:24 AM
Private healthcare + liability insurance = this situation.

Frankly, I'm willing to give the "nurse" the benefit of the doubt. In a highly stressful situtation with a person badgering you on the phone to do something you know is against your works policy to do, most people would have done the same. If she's the sole breadwinner in her family and has dependants to support, I can't imagine her making any other decision.

It sucks, but at some point you need to put the welfare of yourself and your family ahead of other people. It's simply put - not her fault, but the fault of her employers for not covering such a measure (or perhaps more so, the fault of us all for continuing to rely upon private health care providers in this country).

Of course, the irony of this situation is that she will likely be fired ANYWAY because there is no downside to the business for doing so, and only upsides (stopping the negative publicity).
 
2013-03-04 01:02:52 AM

Owangotang: Wow, lots of folks just gleefully missing the point...perform CPR, don't perform CPR, whatever. The appalling part of the story is the way the nurse wanted to pass the buck and "not make that call". Listen dipshiat if you did not want to have to make calls in life or death situations THEN DON'T BECOME A NURSE!


Well, that's the whole point. Whether the dispatcher was right or wrong or the lady was old or feeble or whatever--if the old woman didn't have a written DNR, then when you're told to do CPR, you do it, and that's that. And if you refuse, then you just became liable for that person's death, EVEN IF she would have died anyway, and even if her daughter has "no complaint" with her care at the nursing home or whatever.

Nursing homes have what's called a "duty of care" to their patients which is greater than the normal duty of care owed to people in hotels or whatever. The duty a nurse owes to a patient to ensure her safety and survival is quite high, and just calling 911 if a patient is in distress won't cut it. I have this feeling that the circling buzzards, er, personal injury lawyers have already contacted the daughter and apprised her of just this fact, and she may not be so satisfied with the nursing home's quality of care after a good night's sleep.
 
2013-03-04 01:05:19 AM
I'm pretty sure CPR has never worked.
 
2013-03-04 01:08:55 AM
Acravius:
CPR isn't really for reviving the corpse, its keeping the corpses organs alive long enough for the body to get to improved treatment facilities so that there is a greater capacity for the victim to be revived successfully and with less overall damage.

The manager of the home might have worked as an EMT at some point and feel bad for them.  If an emergency responder arrives and you're doing CPR they have to continue the attempt until delivery to a doctor who can declare it moot.  Even if the body spent a day in the water and you're an insane grief stricken mother.

/Probably not the reason
//known a few EMTs.  They'll tell horrible crash stories that still give them nightmares.  Assisted breathing a corpse, though, even they turn green.
 
2013-03-04 01:10:15 AM

Birnone: Abacus9: Birnone: I wasn't aware that dispatchers could 'talk' you through CPR.  I thought people got certified in that, taking classes and such.

Paramedics get certified, and have special tools they can use too, but anyone can perform CPR. You don't need a certification.

Birnone: I'm guessing further information will show that the 87 year old resident had other issues that would have made it a moot point anyways. It's not like simply doing CPR saves everyone.

So, why bother then? Is that your point?

No, my point was just that outrage over the nurse not 'saving' her is misplaced if she couldn't be saved in the first place.

My evidence that she couldn't be saved in the first place is that she was 87 and needed CPR, two things that when taken together would indicate to me that this person is farked.   What evidence does anyone have that this woman could be saved?


They could have tried. We don't need evidence that it might have worked to just try it, knowing there is a 100% chance she will die without it.
 
2013-03-04 01:11:54 AM

Gyrfalcon: Whether the dispatcher was right or wrong or the lady was old or feeble or whatever--if the old woman didn't have a written DNR, then when you're told to do CPR, you do it, and that's that. And if you refuse, then you just became liable for that person's death, EVEN IF she would have died anyway, and even if her daughter has "no complaint" with her care at the nursing home or whatever.


The dispatcher has no legal authority between the health care provider and the patient other than to provide their service.  Their service does not include creating a subservient legal relationship with someone they are talking to.

As stated up thread, nurse practice acts provide the legal framework of what a nurse can do.  Facilities provide the framework of what a nurse will / should do.  If it was not policy for the nurse at that facility, it would violate the work agreement and that can not only get one fired, but also get marks against one's license (up to losing one's license).

There are scant real details here, but as a take away, nurses, doctors, etc... have rules at every facility they are agents of.  One does not get a license and just 'wing it'.
 
2013-03-04 01:13:19 AM

mccallcl: I did CPR on a guy and he lived. He was quite blue, but he had a pulse. I breathed into his mouth until the ambulance arrived. He returned to pink and breathing right as they showed up. The EMTs seemed almost kinda pissed off. Not sure why. Anyway, breaths only, no compressions.

I think the people who teach CPR have never used it to save a life so they have no idea what they're talking about. You can't hurt anyone by breathing in their mouth.


Sounds like what you did was artificial respiration, not CPR.
 
2013-03-04 01:17:35 AM

Lady Indica: To my knowledge (and I could easily easily be wrong here) there's times where breathing alone is called for. I would think this would be one. Drowning is another. Other than that AFAIK, chest compress is most important (to the tune of Stayin' Alive).


Oddly, "Another One Bites The Dust" also works (roughly the same beats per minute)...
 
2013-03-04 01:17:49 AM
Thanks to the litigious nature of people, this form of policy is not unusual. It all started back in the 60's, when a physician stopped at a car wreck and worked to keep the victim alive until rescue came. (Remember. Back then no cell phones. Landlines had to be used.) Working without equipment, he basically did battlefield care and made an error or two which could not be avoided.

He saved the man's life. After recovering, the guy got a lawyer, who sued the physician for causing him irreparable injuries and .... won.

This opened the door for the major landslide of medical lawsuits that started in the 70's. It also would result in so many people not wanting to get involved that 'Good Samaritan' laws would have to be enacted in many States by the mid 80's.

Medical lawsuits exploded during the 80's, to include institutions, suppliers, designers and laboratories. This resulted in a dramatic increase in health care expenses.

Employers became nearly obsessive about lawsuits. Common sense took a back seat to money. Criminals were finding ways to sue their victims if their victims fought back -- which changed the way many stores handled theft.

In actuality, it was the criminals lawyers who were finding ways to sue the victims.

When working in psychiatrics, I ran afoul of this situation myself. The clinic I worked in had a policy of not getting involved with patients beyond talking who called in at night in distress. This was after one suicidal woman had called in threatening suicide -- a thing she had done many times before -- was fluffed off and went out and hung herself. (I would have thought that would have altered the policy.)

I had a suicide call. The lady had overdosed and went quiet on the phone and was unresponsive. Protocol stated I was to not get involved. She had called in to the patients phone (a pay phone in the day room). So, to keep it brief, I called the cops, gave them the patient's phone number, they ran a trace, got her address, sent out rescue, found her unconscious and took her to the hospital. After pumping her stomach, a few hours later, she was Baker Acted to the clinic I worked in.

I damn near got fired. I was pulled off my shift and placed on the morning shift, under observation and on probation.

However, I'd have done it again.

These days, human life is devalued. You can be sued for stepping in to rescue a person. You can be fired from your job. Everyone is afraid of the Lawyers because they have the ability to make right seem to be wrong and even going to court to defend yourself can be a hideously expensive process. That's why companies will often settle out of court, even if they were in the clear. The court battle to prove it would be more costly than a settlement.

Sometimes, you have to make a judgment call. You have to determine what is more valuable: your job or a human life.
 
2013-03-04 01:19:47 AM

ByOwlLight: WhoGAS: Acravius: Here is CPR: 30 compressions 2 breaths,
                      Repeat 5 times in approximately 2 minutes
                      Assess patient for 10 seconds, listening/looking/feeling for pulse, breath or rise/fall in chest.
                      If no change, resume CPR
                      If AED is available then hook up AED, (Turn On, listen to instructions)
                      Shock, as advised by AED
                      After 3 shocks maximum
                      Assess Patient, as before
                      If no change Resume CPR 5 cycles per 2 minutes, repeat until more qualified personelle come on the scene.
Good Samaritan Laws protect people who use reasonable actions in performing these duties, regardless of outcomes.

So yes it could be instructed over the phone, and still be covered by the Good Samaritan Law.

You don't do breaths any more.

Yes, you do.  30 to 2 is the new standard.  The emphasis is on compressions, now, but breaths haven't been completely cut out, unless you don't feel comfortable doing them.


I took my CPR course when I was 14 in the 80's and they taught us 2 breaths, 15 compressions.

Never been recertified or whatever.  Maybe I should.
 
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