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Archive for March 19th, 2010

The Evolving Science and Guidelines of CPR

Pearl of wisdom for the day: If given the option, don’t let your heart stop.  Very Bad Things soon follow if your heart stops.

In spite of what the entertainment industry would have you believe, it is extremely difficult to save the life of someone in cardiac arrest.  A few random breaths, slow rocking chest compressions, even the ever-so-dramatic overhand blow to the chest accompanied by the scream “Don’t you die on me, dammit!” are unlikely to successfully resuscitate someone following an arrest, and even if it does, they won’t be in any shape to go chase Locke across the island with Jack and Kate five minutes later.

Even with properly performed CPR, started within seconds of an arrest, in a hospital with all the required expertise and support equipment, only roughly half survive their initial arrest event.  Even fewer (25-33%) survive to discharge from the hospital, and ~75% have a good neurologic outcome.  For arrests out of the hospital, where there can be huge delays in treatment, mere survival is significantly lower, often measured in the single digits.

The Limitations Of CPR

Why doesn’t CPR save more people?  Well, it really isn’t meant to; at least, not on its own.  Cardio-respiratory arrest is the common pathway of death, but it isn’t in itself a diagnosis.  The essential question to be answered is why someone stopped breathing, or why their heart stopped in the first place.  Unless you can answer that question and address the problem, even if CPR manages to restore a heartbeat it’s likely to stop again in short order. (more…)

Posted in: Science and Medicine

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