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I was dead on the street at 15 after being hit by a car (my fault). A good Samaritan stopped, administered CPR and resuscitated me. Forty six years later and

I was dead on the street at 15 after being hit by a car (my fault). A good Samaritan stopped, administered CPR and resuscitated me. Forty six years later and I never got to thank him. I only know his first name (Mark). CPR is a good thing and hopefully this article will not make people think twice before administering it.

mbac32768 3y ago
I took a rescue diver certification course and after they went through lots of procedures for how to rescue someone, perform CPR, etc and drilled you in varying ways about it, at the exact end of the course they level with you and say the odds of someone actually recovering from these kinds of dive accidents is dismal. Don't beat yourself up if your patient doesn't survive, you tried your best :thumbsup: I agree these interventions are worth trying but it's definitely important for first responders to be realistic about the success rates so that they aren't haunted by the failures.
davycro 3y ago
CPR shouldn’t work on someone dead from a traumatic injury. For example chest compressions will only hurt someone dead from having their chest crushed against a steering wheel in a car accident. What happened to you is a true miracle and far outside the norm.
gerdesj 3y ago
It is a good thing: obviously - you were resuscitated. I did a first aid course a few months back and one of the attendees (six in total) had done a similar job for a colleague a few years back. Their description was quite something. To be told first hand what happens, corroborating the instructor is a lesson and a half. It isn't pleasant at all and I won't spell it out here. As well as CPR we covered quite a few other things and you are far more likely to encounter choking and the correct response is far more likely to have a good outcome than CPR, so first aid courses are a very good thing. If I end up having to deliver CPR, I will do it without hesitation. I will do the checks first, mindful that I will be performing what amounts to ABH. A small success rate is better than nothing. OK so something like 5-10% is the real success rate for CBR. Now, would you be interested in something like 75%? DEFIBRILLATOR. A defib will talk you through how to use it but a short course will get you going much quicker. They are just like jump starting a car but instead of croc clips, the wires are connected to sticky pads that you stick on the person. They are battery powered and can be very small and portable. They are nothing like as big as you see on old school TV dramas. Upside: ~75% chance of resuss. compared to around 5-10% for CPR. No need to potentially break ribs or other unsavoury side effects of battering a person. Downside: Costs around £1000 a pop - they are reusable. If you own a business, why not grab one, slap it on the wall near to the first aid kit and get the staff clued up. When you get to a certain age (over zero) why not get one at home? I have not yet followed my own advice yet but I think I will quite soon! Have a chat about it with your staff, family and whoever will listen. I think that CPR should be likened to camping without a tent, in the Arctic. A defib: glamping, with free Cava! That said, I will still cause ABH on someone that I deem needs it if nothing else is to hand.
- cykros 3y ago
  Indeed. They've been available on Amazon since Amazon was still known so much as a book store that it made headlines that you could get them there, what with their not being books and all.
- eternityforest 3y ago
  If defibrillators are that effective, making them accessible should be a bigger deal. Why are they so expensive after all this time? Maybe there could be an Emergency App included in all phones with offline first aid info, a deadman switch that calls 911 if you let go of the button, and maps of the building you're in with are and fire escape plans, if they published one. Lots of businesses that could afford one still don't have them, why isn't there any legal requirement for million dollar profit places to have them?
- aaron695 3y ago
  [dead]
- richardjam73 3y ago
  You can now get single use defibrillators that are cheaper but they have a limited life span.
  - cmcaleer 3y ago
    All defibs do. The battery and pads need replaced every few years.
- mullingitover 3y ago
  I think they work best in combination. The CPR can keep your brain alive long enough for the defib to arrive.
- quantumwoke 3y ago
  I appreciate the exuberant tone of this message but it’s not quite correct. Defibrillators can get upwards of 60% success rate if given in conjunction with effective CPR. There’s no getting around breaking ribs - defibrillators have to charge, you have to check the pulse and oxygen has to be given. You can’t leave someone pulseless for 60 seconds while you fetch and charge the defibrillator as they will die. All the first aid tools are used in concert.
whatever1 3y ago
That is why statistics are a horrible tool for decision making. There are so many things that on a statistical basis make no sense. Yet on an individual level it is a life-or-death difference.
- jdietrich 3y ago
  > That is why statistics are a horrible tool for decision making. Statistical illiteracy is a horrible tool for decision making. Statistics is the only tool for decision making other than pure guesswork, because all decisions based on data are statistical inferences. If something doesn't make sense on a statistical basis, it's almost certainly the case that the statistical analysis was naive. A statistical inference of the probability of survival of a particular patient that doesn't take into account any characteristics of that patient is naive in the extreme. We aren't interested in the average patient, we care about the average patient whose risk profile most closely resembles our patient.
SkyPuncher 3y ago
One of the most interesting insights I learned, second-hand from my wife's medical education, is the essentially bi-modal distribution of CPR need. Note: This is an observation based on memory. It may or may not be actually true. * Group One is people like you. Otherwise healthy people who've had some sort of crazy event. CGR gets your body through an acute moment so it can heal and recover on its own. * Group Two. People that are already sick or very sick. Cardiac arrest is essentially their body failing. Even if CPR is successful, they're have lots of physical trauma that is extremely hard to overcome. Another cardiac arrest is inevitable. The article does a terrible job of identifying this difference. If you're a member of the general public and you need to give CPR, there's a huge chance you're giving it to someone in Group One. Most people in Group Two are already hospitalized or in some sort of care setting.
- sebii 3y ago
  This distinction was my take away from the article.
- smorrebrod 3y ago
  Yes, the article says that half of the people resuscitated by CPR wished it didn't happen. The linked paper explicitly says this figure is valid for in-hospital administered CPR, so definitely people belonging to group 2.
- snowwrestler 3y ago
  Yes this was a point of particular emphasis in swiftwater rescue classes since drowning is one of the mechanisms of injury for which CPR can work well to bring someone back who appears dead (not breathing, hard-to-find pulse). It’s also a scenario in which the breathing part of CPR is particularly valuable. A lot of front-country CPR courses de-emphasize administering breaths in favor of sustaining chest compressions.
- iudqnolq 3y ago
  > Most people in Group Two are already hospitalized or in some sort of care setting. No. Disabled and sick people are all around you. This is why you should have been taught in your CPR class to check for a medical ID tag that might, for example, say that the person doesn't want to be resuscitated. Also just because someone is disabled doesn't necessarily mean they don't want CPR. That's their choice and not yours, just respect it. Denying disabled people CPR without consent during the pandemic in the UK and Canada did significant damage to public education around when you might want not want CPR. I learned CPR on a Wilderness First Responder course. They keep adding more medical training because the wilderness is increasingly accessible to disabled and sick people. The sidewalk in the middle of civilization is much easier to get to than that. Edit: This is a reason however to continue CPR longer in certain cases like drowning (especially in cold water) and lightning strikes.
jeroenhd 3y ago
The risks and problems are a lot worse for old people than for teenagers. The story in this article is allot more complicated than "Don't try to revive toddlers or always revive comatose 110 year olds". As important as CPR is, people who will be performing it deserve to know 9 out of 10 people will still end up dead. Nobody gains anything from a bystander blaming himself for the death of someone they could never have saved. For many survivors, life after CPR is a gate worse than death. I'll try to apply CPR should I ever need to, but if I were to end up a vegetable or permanentlysufferimg husk like so many people, I'm pretty sure I'd be begging for euthanasia if I still can. I may not agree with their decision, but I understand why the nurse in the story may have refused. If I get to live to a ripe old age, I'd get whatever do-not-recussitate paperwork I might need.
stefantalpalaru 3y ago
[dead]
lamontcg 3y ago
> I was dead on the street at 15 Big difference between 15 and 85 or 95.
n8henrie 3y ago
CPR successfully resuscitating a traumatic arrest is highly unusual. Consider yourself anomalously lucky.
- JshWright 3y ago
  Especially CPR alone. Assuming a defibrillator wasn't used, there's a non-zero chance this wasn't actually a cardiac arrest, but rather a loss of consciousness and the bystander couldn't find a pulse that was actually present (finding a pulse in a high stress situation is not at all easy to do).
ransom1538 3y ago
I took CPR class quite a few times. One thing I learned, if they are young, there is a good chance it will work. If they are old, there isn't much hope.
- FireBeyond 3y ago
  As a paramedic, somewhat. It's also to do with how -quickly- CPR starts. What -typically- happens (though by no means always) is the heart goes from a normal sinus rhythm to VT (ventricular tachycardia) to VF (ventricular fibrillation) to asystole / PEA (pulseless electrical activity) or similar. Now by all means getting ROSC (return of spontaneous circulation) back doesn't mean everything is golden (indeed many patients re-arrest between home and the hospital), because we haven't fixed the underlying cause (plaque in the arteries, etc.) But similarly, many younger or young adult arrests are often due to congenital defects or issues, diagnosed or not. We obviously don't fix that in the field either. Where your statement is definitely much more true is in pediatric arrests. The vast majority of pediatric arrests are respiratory arrests that deteriorate into cardiac arrest - be it FBAO (foreign body airway obstruction), near-drowning, or similar. If we can fix the root problem - dislodge that foreign body (either by removal, or from the force of compressions), or at least allow enough air through, either naturally or by ventilation, to get to the lungs and re-perfuse the blood, we can usually get ROSC and, because we -have- "solved" (temporarily or otherwise) the root cause, those patients, thankfully, tend not to re-arrest.
blastro 3y ago
CPR saved my dad's life as well
riceart 3y ago
Successful resuscitation after traumatic arrest is extremely rare. It is more rare than bystander field CPR administered to those that are not in actual arrest (unconscious but with a perfusing rhythm). What was the confirmation of arrest? I have been called numerous to bedside for in hospital "arrest" that turned out to be assessment error - that is with trained medical professionals.
- samtho 3y ago
  The value of CPR by is rarely derived from successful resuscitation. In most cases, the person performing CPR is someone who was trained briefly on chest compressions and mouth-to-mouth which to be performed until a EMT arrives or an AED becomes available. The purpose of this procedure is to get some, however small, bit of oxygen into the patient to prevent brain damage.
  - deleted 3y ago
    [deleted]
throwaway049 3y ago
Trauma arrest has a particularly low survive-to-discharge rate so you beat the odds. Speaking as an EMT, we will make every effort anyways - we like beating the odds too!
deleted 3y ago
[deleted]

mbac32768 3y ago

I took a rescue diver certification course and after they went through lots of procedures for how to rescue someone, perform CPR, etc and drilled you in varying ways about it, at the exact end of the course they level with you and say the odds of someone actually recovering from these kinds of dive accidents is dismal. Don't beat yourself up if your patient doesn't survive, you tried your best :thumbsup: I agree these interventions are worth trying but it's definitely important for first responders to be realistic about the success rates so that they aren't haunted by the failures.

davycro 3y ago

CPR shouldn’t work on someone dead from a traumatic injury. For example chest compressions will only hurt someone dead from having their chest crushed against a steering wheel in a car accident. What happened to you is a true miracle and far outside the norm.

gerdesj 3y ago

It is a good thing: obviously - you were resuscitated. I did a first aid course a few months back and one of the attendees (six in total) had done a similar job for a colleague a few years back. Their description was quite something. To be told first hand what happens, corroborating the instructor is a lesson and a half. It isn't pleasant at all and I won't spell it out here. As well as CPR we covered quite a few other things and you are far more likely to encounter choking and the correct response is far more likely to have a good outcome than CPR, so first aid courses are a very good thing. If I end up having to deliver CPR, I will do it without hesitation. I will do the checks first, mindful that I will be performing what amounts to ABH. A small success rate is better than nothing. OK so something like 5-10% is the real success rate for CBR. Now, would you be interested in something like 75%? DEFIBRILLATOR. A defib will talk you through how to use it but a short course will get you going much quicker. They are just like jump starting a car but instead of croc clips, the wires are connected to sticky pads that you stick on the person. They are battery powered and can be very small and portable. They are nothing like as big as you see on old school TV dramas. Upside: ~75% chance of resuss. compared to around 5-10% for CPR. No need to potentially break ribs or other unsavoury side effects of battering a person. Downside: Costs around £1000 a pop - they are reusable. If you own a business, why not grab one, slap it on the wall near to the first aid kit and get the staff clued up. When you get to a certain age (over zero) why not get one at home? I have not yet followed my own advice yet but I think I will quite soon! Have a chat about it with your staff, family and whoever will listen. I think that CPR should be likened to camping without a tent, in the Arctic. A defib: glamping, with free Cava! That said, I will still cause ABH on someone that I deem needs it if nothing else is to hand.

cykros 3y ago
Indeed. They've been available on Amazon since Amazon was still known so much as a book store that it made headlines that you could get them there, what with their not being books and all.
eternityforest 3y ago
If defibrillators are that effective, making them accessible should be a bigger deal. Why are they so expensive after all this time? Maybe there could be an Emergency App included in all phones with offline first aid info, a deadman switch that calls 911 if you let go of the button, and maps of the building you're in with are and fire escape plans, if they published one. Lots of businesses that could afford one still don't have them, why isn't there any legal requirement for million dollar profit places to have them?
aaron695 3y ago
[dead]
richardjam73 3y ago
You can now get single use defibrillators that are cheaper but they have a limited life span.
- cmcaleer 3y ago
  All defibs do. The battery and pads need replaced every few years.
mullingitover 3y ago
I think they work best in combination. The CPR can keep your brain alive long enough for the defib to arrive.
quantumwoke 3y ago
I appreciate the exuberant tone of this message but it’s not quite correct. Defibrillators can get upwards of 60% success rate if given in conjunction with effective CPR. There’s no getting around breaking ribs - defibrillators have to charge, you have to check the pulse and oxygen has to be given. You can’t leave someone pulseless for 60 seconds while you fetch and charge the defibrillator as they will die. All the first aid tools are used in concert.

whatever1 3y ago

That is why statistics are a horrible tool for decision making. There are so many things that on a statistical basis make no sense. Yet on an individual level it is a life-or-death difference.

jdietrich 3y ago
> That is why statistics are a horrible tool for decision making. Statistical illiteracy is a horrible tool for decision making. Statistics is the only tool for decision making other than pure guesswork, because all decisions based on data are statistical inferences. If something doesn't make sense on a statistical basis, it's almost certainly the case that the statistical analysis was naive. A statistical inference of the probability of survival of a particular patient that doesn't take into account any characteristics of that patient is naive in the extreme. We aren't interested in the average patient, we care about the average patient whose risk profile most closely resembles our patient.

SkyPuncher 3y ago

One of the most interesting insights I learned, second-hand from my wife's medical education, is the essentially bi-modal distribution of CPR need. Note: This is an observation based on memory. It may or may not be actually true. * Group One is people like you. Otherwise healthy people who've had some sort of crazy event. CGR gets your body through an acute moment so it can heal and recover on its own. * Group Two. People that are already sick or very sick. Cardiac arrest is essentially their body failing. Even if CPR is successful, they're have lots of physical trauma that is extremely hard to overcome. Another cardiac arrest is inevitable. The article does a terrible job of identifying this difference. If you're a member of the general public and you need to give CPR, there's a huge chance you're giving it to someone in Group One. Most people in Group Two are already hospitalized or in some sort of care setting.

sebii 3y ago
This distinction was my take away from the article.
smorrebrod 3y ago
Yes, the article says that half of the people resuscitated by CPR wished it didn't happen. The linked paper explicitly says this figure is valid for in-hospital administered CPR, so definitely people belonging to group 2.
snowwrestler 3y ago
Yes this was a point of particular emphasis in swiftwater rescue classes since drowning is one of the mechanisms of injury for which CPR can work well to bring someone back who appears dead (not breathing, hard-to-find pulse). It’s also a scenario in which the breathing part of CPR is particularly valuable. A lot of front-country CPR courses de-emphasize administering breaths in favor of sustaining chest compressions.
iudqnolq 3y ago
> Most people in Group Two are already hospitalized or in some sort of care setting. No. Disabled and sick people are all around you. This is why you should have been taught in your CPR class to check for a medical ID tag that might, for example, say that the person doesn't want to be resuscitated. Also just because someone is disabled doesn't necessarily mean they don't want CPR. That's their choice and not yours, just respect it. Denying disabled people CPR without consent during the pandemic in the UK and Canada did significant damage to public education around when you might want not want CPR. I learned CPR on a Wilderness First Responder course. They keep adding more medical training because the wilderness is increasingly accessible to disabled and sick people. The sidewalk in the middle of civilization is much easier to get to than that. Edit: This is a reason however to continue CPR longer in certain cases like drowning (especially in cold water) and lightning strikes.

jeroenhd 3y ago

The risks and problems are a lot worse for old people than for teenagers. The story in this article is allot more complicated than "Don't try to revive toddlers or always revive comatose 110 year olds". As important as CPR is, people who will be performing it deserve to know 9 out of 10 people will still end up dead. Nobody gains anything from a bystander blaming himself for the death of someone they could never have saved. For many survivors, life after CPR is a gate worse than death. I'll try to apply CPR should I ever need to, but if I were to end up a vegetable or permanentlysufferimg husk like so many people, I'm pretty sure I'd be begging for euthanasia if I still can. I may not agree with their decision, but I understand why the nurse in the story may have refused. If I get to live to a ripe old age, I'd get whatever do-not-recussitate paperwork I might need.

stefantalpalaru 3y ago

[dead]

lamontcg 3y ago

> I was dead on the street at 15 Big difference between 15 and 85 or 95.

n8henrie 3y ago

CPR successfully resuscitating a traumatic arrest is highly unusual. Consider yourself anomalously lucky.

JshWright 3y ago
Especially CPR alone. Assuming a defibrillator wasn't used, there's a non-zero chance this wasn't actually a cardiac arrest, but rather a loss of consciousness and the bystander couldn't find a pulse that was actually present (finding a pulse in a high stress situation is not at all easy to do).

ransom1538 3y ago

I took CPR class quite a few times. One thing I learned, if they are young, there is a good chance it will work. If they are old, there isn't much hope.

FireBeyond 3y ago
As a paramedic, somewhat. It's also to do with how -quickly- CPR starts. What -typically- happens (though by no means always) is the heart goes from a normal sinus rhythm to VT (ventricular tachycardia) to VF (ventricular fibrillation) to asystole / PEA (pulseless electrical activity) or similar. Now by all means getting ROSC (return of spontaneous circulation) back doesn't mean everything is golden (indeed many patients re-arrest between home and the hospital), because we haven't fixed the underlying cause (plaque in the arteries, etc.) But similarly, many younger or young adult arrests are often due to congenital defects or issues, diagnosed or not. We obviously don't fix that in the field either. Where your statement is definitely much more true is in pediatric arrests. The vast majority of pediatric arrests are respiratory arrests that deteriorate into cardiac arrest - be it FBAO (foreign body airway obstruction), near-drowning, or similar. If we can fix the root problem - dislodge that foreign body (either by removal, or from the force of compressions), or at least allow enough air through, either naturally or by ventilation, to get to the lungs and re-perfuse the blood, we can usually get ROSC and, because we -have- "solved" (temporarily or otherwise) the root cause, those patients, thankfully, tend not to re-arrest.

blastro 3y ago

CPR saved my dad's life as well

riceart 3y ago

Successful resuscitation after traumatic arrest is extremely rare. It is more rare than bystander field CPR administered to those that are not in actual arrest (unconscious but with a perfusing rhythm). What was the confirmation of arrest? I have been called numerous to bedside for in hospital "arrest" that turned out to be assessment error - that is with trained medical professionals.

samtho 3y ago
The value of CPR by is rarely derived from successful resuscitation. In most cases, the person performing CPR is someone who was trained briefly on chest compressions and mouth-to-mouth which to be performed until a EMT arrives or an AED becomes available. The purpose of this procedure is to get some, however small, bit of oxygen into the patient to prevent brain damage.
- deleted 3y ago
  [deleted]

throwaway049 3y ago

Trauma arrest has a particularly low survive-to-discharge rate so you beat the odds. Speaking as an EMT, we will make every effort anyways - we like beating the odds too!

deleted 3y ago

[deleted]