Not exactly mundane or pointless… kinda sad actually, IMHO.
New England Journal of Medicine article reviews neighborhood characteristics and concludes you are less likely to get CPR from a bystander if you are a minority or in a poor neighborhood. Poverty was a stronger influence.
This seems to confirm my experience working in a 9-1-1 center. I am saddened and disappointed at the frequency with which people refuse to attempt CPR even though I tell them I can provide step-by-step directions.
Call 9-1-1. Push hard and fast in the center of the chest. 80-100 beats per minutes, about the tempo of the BeeGees song Stayin’ Alive. Keep going until the ambulance arrives.
I was the only one in my CPR class who didn’t raise my hand when the instructor ask who here would perform CPR on a homeless person. Higher rate of possible diseases was my concern. He told us, just because we can perform CPR doesn’t mean we have to if we feel there is risk to ourselves.
New CPR training (IIRC) avoids rescue breaths altogether and concentrates on chest compressions, so you won’t get diseases that way. The sad thing is, as stated in the OP, the vast majority of the cases happened in the home, so that wasn’t even a concern.
(They also make CPR breathing mouthpieces small enough to attach to your keychain in a small pouch, but that’s not really as much of a concern these days.)
I wonder if anyone’s done any studies on differences in family involvement in medical caregiving overall. I only have a few dozen families, and very few of them white and even fewer of them affluent, so my sample size is decidedly inadequate and not statistically representative. But I feel like I am noticing that minority and poor families are more hesitant to provide hands on care than white and/or affluent folks, period. They resist learning how to care for relatively minor wounds, they don’t help their sick family member bathe in between CNA visits, they don’t help them change into clean clothes every day or even every few days, they leave them in bed more, rather than help them get up and move to a chair. I’m not sure I could begin to venture a guess as to why, except that it’s clearly not for lack of love or affection, or even ignorance of the skills needed. It seems more like fear of inadequacy - some of my families tell me it’s “not [their] job, [they’re] not a nurse”, others seem afraid they’re going to hurt the sick family member. Sometimes I can build up their confidence and get them more involved, but more often the patient ends up in a nursing home even when there are competent capable adults living in the same home with them.
If you’re not a BeeGees fan you can do CPR to Another One Bites the Dust by Queen. Hands only CPR is the rule for untrained rescuers or if you don’t have a mouthpiece. I carry a mouthpiece (one way valve) EVERYWHERE. I am quite literally never more than a few feet away.
I have to agree with my fellow home health nurse Whynot on the families that are reluctant to help. My patients and families are overwhelmingly white, but the more affluent families are more likely to help the patient with Activities of Daily Living (ADLs for short) than poorer families. Personally, I think it has to do with feeling more successful in the world but I have been too busy to analyze it. I can’t get some families to do wound care that is no more complicated than I could teach an 11 year old Boy Scout to do, and I have one who manages 2 separate IV pumps, a triple lumen PICC line flushes, JP drain flushes, NG tube suction and a colostomy!
“Staying Alive” is an upbeat title of a song when trying to keep someone alive. “Another One Bites The Dust” would not be ironically amusing in those circumstances.
I think that its lack of education and experience. Many people don’t want to do damage, so would opt out instead of doing something that might possibly cause harm
I’ve been doing animal rescue for a very long time, and I still hesitate when I’m reaching out to rescue a downed critter.
People who have never seen wound care treated as routine would probably have issues.
Just hope they have an Android/iOS smartphone and have downloaded the British Heart Federation’s pocket CPR app. You wrap one hand around one end of the phone, put your other hand on the proper spot on the chest (following the step-by-step guidelines on the app) and phone-holding hand on top, and push down until the phone beeps. It’ll prompt you with the appropriate rhythm and everything. Best yet, you can use it to practice on a couch cushion or CPR dummy.
Pffft. I’ll be counting to 30 out loud and be lucky to have breath to do that within 2 to 3 minutes, not singing. The song is playing in my head to help me keep the compressions fast enough.
“Call My Maybe” will work, too, and God knows most of us have that stuck in our head!
New things are scary.
Poverty might result in people not having had any first-aid training that more affluent families would take for granted. I know I got first aid training as a girl scout, and CPR training as a required job-related class a long time ago.
Many times if I tell a caller to move (drag/roll/shove) a patient off a bed and onto the floor so we can do CPR, the caller refuses saying the patient will hit his/her head.
CPR will not make the patient “more dead”. I am absolutely certain the patient would rather wake up in the hospital with a bump on the head and a couple broken ribs than not wake up at all.
WAG: poverty correlates highly with lack of education, and it makes sense that that would correlate with a lower sense of your own competence at learning new skills. If you’ve been educated through college, then you’ve learned (at least to a basic level) a wide range of stuff, from algebra through recorder through Spanish through how to dissect a frog - so when someone says ‘Right, I’ll walk you through CPR/wound care/whatever,’ you assume you’re well able for this, too. But if you dropped out of high school and didn’t have a great learning experience while you were there, maybe you’re less likely to take it for granted that you’re able to learn something new.
A couple of guesses: (i) poor people are most often standing by other poor people and (ii) poor people know CPR at a lower rate than non-poor people. Both of those would seem to add up to the conclusion in the study.
