Again, I have seen hundreds of people survive after CPR and out of hospital resuscitation. Many had minimal consequences. It is true this sample is biased because of decisions on whom to transport to an emergency department.
In the absence of hypothermia it is hard for me to see codes going longer than fifteen minutes with no improvement. I have seen pediatric codes go longer but only out of desperation. Again, cardiac ultrasound has changed this game because you can detect activity too weak to generate a pulse or confirm a lack of pulsation despite giving appropriate medications and interventions.
What a harrowing experience. I’m so glad your wife is doing better.
As far as laypeople go, I recently had a CPR training where the nurse told us that you aren’t legally required to render medical aid, but if you start, you can’t legally stop until someone better trained than you takes over.
She also said not to worry about hurting the patient during CPR because they are already dead and you can’t make them worse than dead.
I question the “can’t legally stop” assertion. I’ve been teaching CPR for 15 years and never heard that. There are situations where its considered OK to stop but unlawful to do so? Show me the law. Not you in particular, Spice Weasel. .Anyone.
The code can be stopped as soon as the leader deems it futile. However, in practice, one usually gives at least some medication and CPR. My usual practice is to ask every health provider in the room if they are okay with stopping the code once it is clear (and ideally confirmed by ultrasound and thermometer) that further efforts are extremely unlikely to help.
I don’t think it is illegal - I really don’t see how it could be. I have come across a few websites that say something like this
You can’t simply stop giving CPR any time you want to. This is considered gross negligence, and you are not protected by the Good Samaritan statutes.
or
Although California state law requires that you see through care once you begin, there are certain circumstances where you can stop CPR. These are important to know and although they won’t prevent a lawsuit, these conditions are guaranteed by the state of California.
At most, you might get sued for ending CPR and the Good Samaritan law might not protect you. Might, because not only can anybody sue for anything but also because none of the cites I found are from law firms. But that’s not what people normally mean by “illegal” - when someone says you can’t do something “because it’s illegal” they usually mean it’s prohibited by some criminal law, and I couldn’t find anything that says it would ever be a crime for a non-medical professional to stop performing CPR. I remember at the beginning of CVID when NYC stopped transporting when circulation didn’t return after 20 minutes of CPR - people in other places were surprised that NYC had been transporting to the hospital in those circumstances.
I wonder if the people who say " You don’t have to start but once you do you can’t stop" realize that all that does is discourage people from trying. Like some of the people I worked with - when we were getting trained to use Narcan nasal spray they didn’t bother to take a kit because they would let someone die of an overdose right in front of them for fear of getting sued.
Doreen pretty much nailed it. It’s not illegal per se for a private individual to stop CPR. (Different states will have different statutes and regs about what emergency responders are obligated to do.)
It’s just that the Good Samaritan Act in any particular state will likely not protect you from the (usually negligible) threat of lawsuit if you stop without certain criteria being met.
It falls under the category of abandonment, terminating a victim-rescuer relationship inappropriately. The fundamental idea is that if you hadn’t begun care, some other person might have. Thus if you subsequently abandon the victim/patient prematurely your actions may leave the patient worse off than if you hadn’t started.
Certain situations always allow you to stop resuscitation:
another qualified person takes over.
the patient shows signs of life.
a physician orders resuscitation stopped.
you are too exhausted to continue.
When teaching EMTs I always add:
a valid DNR is produced by family.
you become aware of other more salvageable patients (triage)
Bumped. She had been discharged but after two days at home she was so utterly weak. The docs had us come back in, and they found that her blood pressure was very low. She was admitted for another ten days to get that under control while they also treated the bacterial infection in her blood stream. Then they transferred her to a rehab facility and she was there for a week, getting stronger.
Two days ago she was discharged from rehab. She is home now, negotiating the stairs with some difficulty. She is weak and she tires easily, and she needs a cane to walk. But she is building up her strength with each passing day. Given time and exercise, she should recover 100%. Mentally she is already 100% and showing no signs of oxygen deprivation. What a miracle this is! Modern medicine can do a great deal. Truly amazing.
It’s been over five weeks since that Sunday night, 12 November, when her heart stopped and she was revived with CPR. She could have died that night. As many of you know I am a man of faith and during this time many family and friends were praying for her. Our prayers were answered with the outcome we all asked for, thank God. If the outcome had been different I’d like to think that my faith would still be just as strong. Admittedly that is easy to say, now. You don’t really know until you’ve been through it, I guess. But my faith remains strong.
Thank you for the update. I’m sorry to hear about the setbacks, but I’m glad to hear your wife is recovering at home again. Christmas presents don’t get much better.
I want to urge you again to take care of yourself (as well as taking care of your wife, obv). As I said before, in many ways, my MI has been much harder on my wife and kid than on me.
Well I am very glad that you made it, and yeah that experience must’ve been so hard on your wife. I hope that over time your family can recover from that shock.
A bump to again thank everyone for your good thoughts, well wishes, and prayers, and to share that my wife continues her recovery some 18 months later. It has been a long road and fortunately one with a good prognosis for eventual complete recovery. She’s still out on full disability because at her company there’s no such thing as partial disability. It’s all or nothing. She could probably work a few hours each weekday, but it’s a good thing that she doesn’t because she does rest for most of each day.
Yesterday morning we went to a Cars & Coffee event. Here we are:
And this morning on my calendar I noticed that we went to this event once before, on the very day before she almost bled out and died. So it has also been 18 months between Cars & Coffee events.
When her heart stopped for some 20 minutes we were so very fortunate to have already been in the hospital. With that pretty cool LUCAS device described upthread, oxygenated blood was always flowing to her brain. Critical, and crucial.
We remain humbled and grateful for blessings great and small.
