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Salient data from the article: TL;DR CPR slightly increases the odds for someone otherwise healthy and young but is much less effective for the old and the chr

Salient data from the article: TL;DR CPR slightly increases the odds for someone otherwise healthy and young but is much less effective for the old and the chronically ill. IIRC from prior CPR classes (own life data), 'correctly done' chest compressions are extremely violent, they often break ribs to get that compression of the heart between the rib cage and spine. It's a last-ditch effort with COSTS. If there's an AED around to use instead that would be FAR more preferable. """ But the true odds are grim. In 2010 a review of 79 studies, involving almost 150,000 patients, found that the overall rate of survival from out-of-hospital cardiac arrest had barely changed in thirty years. It was 7.6%. Bystander-initiated CPR may increase those odds to 10%. Survival after CPR for in-hospital cardiac arrest is slightly better, but still only about 17%. The numbers get even worse with age. A study in Sweden found that survival after out-of-hospital CPR dropped from 6.7% for patients in their 70s to just 2.4% for those over 90. Chronic illness matters too. One study found that less than 2% of patients with cancer or heart, lung, or liver disease were resuscitated with CPR and survived for six months. """

starwatch 3y ago
> 'correctly done' chest compressions are extremely violent. For a good visual of this take a look at a LUCAS machine in operation [1]. I'm a (retained) firefighter and have seen paramedics deploy a LUCAS - it's quite a thing to behold. > If there's an AED around to use instead that would be FAR more preferable. Sadly AED's aren't always appropriate. They need a "shockable rhythm" - that is if your heart is in ventricular tachycardia or ventricular fibrillation [2]. One interesting fact I recall reading (source long forgotten ...) is that collapsed women are less likely to be helped with AED's by passers by. This is because they feel uncomfortable uncovering the chest to apply the AED pads. [1]: https://youtu.be/G-oPJV1LYaE?t=314 https://youtu.be/G-oPJV1LYaE?t=314 [2]: https://www.mayoclinic.org/diseases-conditions/heart-arrhythmia/in-depth/automated-external-defibrillators/art-20043909 https://www.mayoclinic.org/diseases-conditions/heart-arrhyth...
- EA-3167 3y ago
  This is sadly true, a friend and colleague of mine passed away about 7 years ago from sudden cardiac arrest. There was an AED in the building, but unfortunately he was in asystole, nothing there to shock. Having said that AED's do save a lot of lives, but like CPR they aren't magic.
- deanCommie 3y ago
  Holy shit... I had read that chest compressions for CPR are much more aggressive than people imagine and rips being broken is not uncommon. The first few seconds of that clip though made me physically wince with discomfort... wow!
- dreamcompiler 3y ago
  This is why you cannot learn CPR by watching people do it on TV. The actor playing dead would be seriously injured if they were receiving proper CPR.
Eji1700 3y ago
I swear this comes up every 2-5 years. It's insanely violent, doesn't work as well on the elderly (like literally everything else), and is still better than nothing. Things like this almost feel like fear bait. It's intuitive that a procedure performed on someone who's dying is ALWAYS going to be less effective on the elderly. So long as it's not killing more people than it helps (extremely unlikely given the whole "you're not breathing/your heart has stopped" qualifier) it's still an important thing to know.
- michael1999 3y ago
  Quality of life is not a boolean variable. "CPR-induced consciousness" sounds like a truly terrible way to go, and likely to cause real suffering in the practitioner/torturer.
- henry2023 3y ago
  About 93% of the time it's worst than nothing.
  - dghlsakjg 3y ago
    The doing nothing treatment leads to death 100% of the time since you don't do CPR on people with a beating heart.
  - pessimizer 3y ago
    Slightly worse than nothing; saves a tiny bit of exercise for someone. 7% of the time it saves a life.
  - mjevans 3y ago
    For bystanders, the raw numbers from the article reflect a 7.6% survival rate became a 10% survival rate. An absolute improvement in about 24 out of 1000 cases, though for those that do 'survive' maybe a 33% increase? Though those numbers strongly hint at over simplified variables. Is there other medical help available? (E.G. an AED, maybe combined with CPR?) Is EMS close? Are they near a medivac capable landing site and a level 1 trauma center? How does this change across patient demographics? For my own health, this goes back to end of life management questions, can I recover or even improve to a degree if a procedure is done? As someone with hopefully decades and maybe even a chance at upload or archival if I live long enough CPR probably is worth it for the cases where survival is improved; but only if all the other options are exhausted first.
frederikvs 3y ago
> If there's an AED around to use instead that would be FAR more preferable. AEDs still require chest compressions. In fact, they'll give you rhythm to follow and talk you through it. I would expect a very similar rate of injuries from compressions - perhaps a bit less if the AED means the compressions don't need to be performed for the same length of time.
asdfjasgoinio 3y ago
>If there's an AED around to use instead that would be FAR more preferable. This is dangerously wrong. Availability of an AED does NOT eliminate the need to know CPR. A defibrillator is useful only for certain types of heart rhythm, namely v-tach and v-fib. It is of no use whatsoever for other rhythms. The AED itself will detect the type of rhythm and will only administer a shock if it is indicated. If the AED does not detect a shockable rhythm, the machine instruct the user to perform CPR. https://www.proacls.com/wiki/acls-algorithms/shockable-rhythms/ https://www.proacls.com/wiki/acls-algorithms/shockable-rhyth... Even if an AED is available, it will not arrive immediately. Even a short lapse in chest compressions can cause lasting damage. It is necessary to give CPR for even the few seconds until the AED is connected. https://www.redcross.org/take-a-class/cpr/performing-cpr/cpr-steps https://www.redcross.org/take-a-class/cpr/performing-cpr/cpr...
hnthrowaway8860 3y ago
If you are ever in the situation, what will you do? I will certainly peform CPR. Even after reading the article. Why? Most likely the person is dead anyway, no harm done. But if I don't do it, chances are their family sue me for millions. Especially in the US. Unlikely to succeed, but the risk is far from 0. If they win, my life is ruined. I the face of that, I might even consider a settlement for a large sum. Also terrible. So yeah, sorry old ladies. Such articles, a much as I appreciate the educative effects, could even make this worse, since if it's more widely known then I could get sued in either case. Like, I did CPR, lady dies anyway but there were clear signs that she suffered. Great, now I'll have a lawsuit in addition to the trauma of having crushed the ribs of an old lady.
- mjevans 3y ago
  I'm not really fit enough to compress properly, nor have I been in CPR training recently. In an emergency my support role would be better spent on comms support or managing other trauma.
- kbelder 3y ago
  Are there any instances of anybody -- outside of medical professionals -- being sued for not administering CPR? I was told no, but that was decades ago.

starwatch 3y ago

> 'correctly done' chest compressions are extremely violent. For a good visual of this take a look at a LUCAS machine in operation [1]. I'm a (retained) firefighter and have seen paramedics deploy a LUCAS - it's quite a thing to behold. > If there's an AED around to use instead that would be FAR more preferable. Sadly AED's aren't always appropriate. They need a "shockable rhythm" - that is if your heart is in ventricular tachycardia or ventricular fibrillation [2]. One interesting fact I recall reading (source long forgotten ...) is that collapsed women are less likely to be helped with AED's by passers by. This is because they feel uncomfortable uncovering the chest to apply the AED pads. [1]: https://youtu.be/G-oPJV1LYaE?t=314 https://youtu.be/G-oPJV1LYaE?t=314 [2]: https://www.mayoclinic.org/diseases-conditions/heart-arrhythmia/in-depth/automated-external-defibrillators/art-20043909 https://www.mayoclinic.org/diseases-conditions/heart-arrhyth...

EA-3167 3y ago
This is sadly true, a friend and colleague of mine passed away about 7 years ago from sudden cardiac arrest. There was an AED in the building, but unfortunately he was in asystole, nothing there to shock. Having said that AED's do save a lot of lives, but like CPR they aren't magic.
deanCommie 3y ago
Holy shit... I had read that chest compressions for CPR are much more aggressive than people imagine and rips being broken is not uncommon. The first few seconds of that clip though made me physically wince with discomfort... wow!
dreamcompiler 3y ago
This is why you cannot learn CPR by watching people do it on TV. The actor playing dead would be seriously injured if they were receiving proper CPR.

Eji1700 3y ago

I swear this comes up every 2-5 years. It's insanely violent, doesn't work as well on the elderly (like literally everything else), and is still better than nothing. Things like this almost feel like fear bait. It's intuitive that a procedure performed on someone who's dying is ALWAYS going to be less effective on the elderly. So long as it's not killing more people than it helps (extremely unlikely given the whole "you're not breathing/your heart has stopped" qualifier) it's still an important thing to know.

michael1999 3y ago
Quality of life is not a boolean variable. "CPR-induced consciousness" sounds like a truly terrible way to go, and likely to cause real suffering in the practitioner/torturer.
henry2023 3y ago
About 93% of the time it's worst than nothing.
- dghlsakjg 3y ago
  The doing nothing treatment leads to death 100% of the time since you don't do CPR on people with a beating heart.
- pessimizer 3y ago
  Slightly worse than nothing; saves a tiny bit of exercise for someone. 7% of the time it saves a life.
- mjevans 3y ago
  For bystanders, the raw numbers from the article reflect a 7.6% survival rate became a 10% survival rate. An absolute improvement in about 24 out of 1000 cases, though for those that do 'survive' maybe a 33% increase? Though those numbers strongly hint at over simplified variables. Is there other medical help available? (E.G. an AED, maybe combined with CPR?) Is EMS close? Are they near a medivac capable landing site and a level 1 trauma center? How does this change across patient demographics? For my own health, this goes back to end of life management questions, can I recover or even improve to a degree if a procedure is done? As someone with hopefully decades and maybe even a chance at upload or archival if I live long enough CPR probably is worth it for the cases where survival is improved; but only if all the other options are exhausted first.

frederikvs 3y ago

> If there's an AED around to use instead that would be FAR more preferable. AEDs still require chest compressions. In fact, they'll give you rhythm to follow and talk you through it. I would expect a very similar rate of injuries from compressions - perhaps a bit less if the AED means the compressions don't need to be performed for the same length of time.

asdfjasgoinio 3y ago

>If there's an AED around to use instead that would be FAR more preferable. This is dangerously wrong. Availability of an AED does NOT eliminate the need to know CPR. A defibrillator is useful only for certain types of heart rhythm, namely v-tach and v-fib. It is of no use whatsoever for other rhythms. The AED itself will detect the type of rhythm and will only administer a shock if it is indicated. If the AED does not detect a shockable rhythm, the machine instruct the user to perform CPR. https://www.proacls.com/wiki/acls-algorithms/shockable-rhythms/ https://www.proacls.com/wiki/acls-algorithms/shockable-rhyth... Even if an AED is available, it will not arrive immediately. Even a short lapse in chest compressions can cause lasting damage. It is necessary to give CPR for even the few seconds until the AED is connected. https://www.redcross.org/take-a-class/cpr/performing-cpr/cpr-steps https://www.redcross.org/take-a-class/cpr/performing-cpr/cpr...

hnthrowaway8860 3y ago

If you are ever in the situation, what will you do? I will certainly peform CPR. Even after reading the article. Why? Most likely the person is dead anyway, no harm done. But if I don't do it, chances are their family sue me for millions. Especially in the US. Unlikely to succeed, but the risk is far from 0. If they win, my life is ruined. I the face of that, I might even consider a settlement for a large sum. Also terrible. So yeah, sorry old ladies. Such articles, a much as I appreciate the educative effects, could even make this worse, since if it's more widely known then I could get sued in either case. Like, I did CPR, lady dies anyway but there were clear signs that she suffered. Great, now I'll have a lawsuit in addition to the trauma of having crushed the ribs of an old lady.

mjevans 3y ago
I'm not really fit enough to compress properly, nor have I been in CPR training recently. In an emergency my support role would be better spent on comms support or managing other trauma.
kbelder 3y ago
Are there any instances of anybody -- outside of medical professionals -- being sued for not administering CPR? I was told no, but that was decades ago.