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What's the point of this article? Are we trying to get rid of CPR now so that people don't bother doing it because it has a low success rate? It is literally
by boringg 3y ago
What's the point of this article? Are we trying to get rid of CPR now so that people don't bother doing it because it has a low success rate? It is literally a last desperate effort to save someone in a really bad situation.
I don't think anyone is under the allusion that CPR has like a 95% success rate do they?
- nordsieck 3y ago> I don't think anyone is under the allusion that CPR has like a 95% success rate do they? When I was first taught CPR in school, it was taught without any reference to the survival statistics. The impression I got was that it was very effective. I don't know about 95% success rate, but I'd bet a lot of people think it has at least a 70% success rate.
- querez 3y agoWhen I was thought it, it was clearly pointed out to me that chance of survival is ~5%, but increases significantly if an AED can be used in time. I've also been told about the rib cracking etc. Just as a counterpoint.
- basisword 3y agoWhat use is this information though to someone performing CPR? It’s important in the sense that maybe better techniques can be developed but if I need CPR it doesn’t matter one bit if the person doing it knows it’s success rate. In fact probably better they don’t know. If they know the odds are low perhaps they’ll give up too soon.
- WJW 3y agoI could see an argument that knowing the statistics could help the CPR-giver in the aftermath. After all the patient is very likely to die and if the CPR-giver was under the impression that it is likely to work, then they may feel a lot of unwarranted guilt.
- dragonwriter 3y ago> What use is this information though to someone performing CPR? Possibly quite important to their psychological condition afterwards, given what the very low effectiveness means.
- Sohcahtoa82 3y agoTo absolve themselves of guilt and self-doubt. Someone who doesn't know that CPR has a very low success rate might perform CPR on someone that ends up not surviving and feeling guilty and full of self-doubt, thinking they performed CPR incorrectly.
- lazyasciiart 3y agoThere was a Reddit thread from someone who had spent years feeling that exact guilt for not saving her grandma https://www.reddit.com/r/BestofRedditorUpdates/comments/102kp42/when_i_was_24_we_were_celebrating_christmas_my/ https://www.reddit.com/r/BestofRedditorUpdates/comments/102k...
- yarg 3y agoI know a dude who's a very competent ambo, he saw a man collapse and immediately rebooted his heart with a single perfect strike to the chest. Beyond the prior state of the patient, technique can actually matter as well - but the fact is that the vast majority of people are never going to develop skills beyond "ah ah ah ah staying alive".
- BloominOnion 3y agoSounds like he administered a precordial thump.
- throwaway173738 3y agoI was taught it was not terribly effective except in case of lightning strike. We weren’t taught how to do it in Mountaineering-Oriented First Aid because of that, and because the leadership, wound care, trauma, and specific conditions aspects of the course took almost the whole three days.
- duskwuff 3y agoCPR is particularly unlikely to be life-saving in a wilderness scenario (like mountaineering) because professional medical care may be many hours away. Even if you can get a patient's heart restarted with CPR, they may not survive to reach a hospital.
- asperous 3y agoThe article links a source and says "In real life, people similarly believe that survival after CPR is over 75%"
- bscphil 3y agoThe real problem with the article is that it's conflating two things: the absolute rate of survival for cardiac arrest after CPR, and the relative rate of survival for cardiac arrest after CPR (versus doing nothing). > In real life, people similarly believe that survival after CPR is over 75%. I'm just a medically ignorant rando, my naive guess was that people survive cardiac arrest without intervention 30% of the time (per the article, the actual rate is 7.6%). Unless you measure people's beliefs about this, you won't be able to determine whether 75% is a good rate or a bad one. Apparently bystander initiated CPR, out of the hospital, increases those odds to 10%. That means that a third more people will survive if bystanders initiate CPR. That seems ... really good to me? In the hospital, survival after CPR goes up to 17%, which is an increase of 2.2 times! It's actually pretty comparable to someone having naive guesses of 75% CPR survival vs 30% without CPR. (My actual guess was that CPR made a difference about 20% of the time, so all these numbers are way better than that.)
- beams_of_light 3y agoI guess we’re in a state where any reporting is meant to change behaviors?
- George83728 3y agoWhen the American Red Cross trained me in CPR, they told me this statistic, and told me that the reason they told me this was so that I wouldn't blame myself if the victim dies anyway (the most likely outcome.)
- jeffrallen 3y agoThis was true in a recent Swiss training as well.
- ghostpepper 3y agoThey link a study where they polled people shortly after a family member was admitted to the ICU about the effectiveness of CPR. My partner is a nurse, so I already knew that the odds of community-delivered CPR were about 10% (although now I'm curious how those odds change when an AED is available) and about the cracking of ribs. I think what this article could've emphasized more is that more people should learn about and consider Advance Directives and DNR (do not resuscitate orders), particularly for patients who are nearing the end of their natural life. As it reads now it seems to suggest that bystanders should not bother doing CPR in the community, which I think is incorrect and borderline dangerous advice.
- Gordonjcp 3y ago> (although now I'm curious how those odds change when an AED is available) AEDs are fucking magical. They even talk to you to tell you how to use them. If the need arises, get the AED and get going.
- koheripbal 3y agoIsn't an AED only useful for tachycardia? I'm case of drowning, heart attack, or most other causes of a stopped heart, it isn't useful, correct?
- tux3 3y agoI think AEDs can also pace these days if it's brady (but not asystole)
- JshWright 3y agoI'm not aware of any AEDs that will pace. There are devices that can function as both an AED and an external pacer. Most cardiac monitors used in ambulances have an AED mode that can be used by EMTs, in addition to the more advanced features (transcutaneous pacing, cardioversion, manual defibrillation, etc). Those are the sort of thing a layperson is going to come across as an "AED" though.
- MengerSponge 3y agoDoing CPR is scary and hard, and if it's okay to teach people that while it probably won't work, it won't make things worse, and if you're lucky it'll save a life. Transparency is a small kindness to help the people who do CPR not beat themselves up when it (probably) fails. *illusion (sorry)
- groestl 3y agoI think the risk that people don't even start if they worry about survival rates is higher.
- henry2023 3y ago> it won't make things worse Maybe you should read the article.
- dghlsakjg 3y agoOne of the preconditions for CPR treatment is that the patient has no heartbeat. The patient is dead, or going to be dead (depending on how you define dead) very shortly without CPR. So, while the side effects of CPR can be pretty bad, not receiving CPR means guaranteed death. That's what people mean when they say it won't make things worse.
- oatmeal1 3y agoI would recommend reading the article.
- strunz 3y agoSeriously, it's crazy how many people on here clearly didn't read it. I feel like I'm on Reddit. It says specifically: >In real life, people similarly believe [1] that survival after CPR is over 75%. [1] https://pubmed.ncbi.nlm.nih.gov/25711518/ https://pubmed.ncbi.nlm.nih.gov/25711518/
- matkoniecz 3y agoMake people aware that performing CPR on terminally ill people is not self-evidently a good idea. See "A 'natural death' may be preferable for many than enduring CPR" which is a title. > She has written about performing chest compressions on a frail, elderly patient and feeling his ribs crack like twigs. She found herself wishing she were "holding his hand in his last dying moments, instead of crushing his sternum." She told me that she's had nightmares about it. She described noticing his eyes, which were open, while she was performing CPR. Blood spurted out of his endotracheal tube with each compression. > "I felt like I was doing harm to him," she told me. "I felt like he deserved a more dignified death."
- boringg 3y agoAgree completely - in that instance the individual should have some kind of DNR bracelet. That burden falls on the communication of the individual to wear something indicating DNR or requires an assessment at the time by the first responder to decide it isn't worth trying to save the individual and provide comfort instead. I think that assessment by a first responder is a very difficult decision to put on someone.
- jdietrich 3y ago>Agree completely - in that instance the individual should have some kind of DNR bracelet. Even if you wear a DNR bracelet, there's a good chance that it'll be ignored. Bystanders often don't know to look for them and have no legal obligation to abide by them. Healthcare professionals routinely err on the side of caution if there is any doubt about the validity of a DNR order, in no small part because wrongful prolongation of life lawsuits are generally much less costly than wrongful death lawsuits. Advance healthcare planning is a much more complicated business than simply wearing a bracelet. We need a broad societal conversation about end-of-life care, not least because DNRs are often misunderstood by both patients and healthcare professionals.
- boringg 3y agoI'm offering a simple first step to a complex situation. I don't think the default option is let's not help older people and resort to comfort.
- yarg 3y agoSurvival rates aside, CPR on the elderly can be particularly brutal. CPR is basically beating the crap out of someone in order to drag them back from death. You're talking about inflicting serious damage on people who take damage more easily, struggle to recover and are significantly more likely to suffer medical complications from even minor injuries. We like to place human life in an echelon of the sacred above all other life - and sometimes this leads to us being kinder to our pets than we are to ourselves. A healthcare system that prioritises quality over quantity of life could yield better results, but that's not going to happen as long as things are controlled by a gluttonous hydra of an industry that has a fiduciary duty to its stockholders, but no real duty of care to the patients.
- User23 3y agoRight. Doing nothing has a near zero recovery rate for cardiac arrest. Any intervention needs to be judged against the real alternatives and not some imaginary ideal case.
- grogenaut 3y agounless we're actively killing more people by doing cpr by accident than would have lived it's a net positive even if it's 1%. If you had a 1% chance to save your kid by oddly palpitating their chest... I'm betting you'd do it. Tho as we all know you have to say "live damn you live" and cry a bunch for it to work.
- aeternum 3y agoSure but what if you have a 2% chance of saving them by a thump to the heart, or a 20% chance by running to the store/business a couple blocks away and grabbing their AED.
- grogenaut 3y agoDuring that time, a few blocks, they're likely been out for now 2+ minutes or more. Or you could you know, yell and get other people to call 911 and find an AED.