People Think CPR is More Effective Than It Really Is, Study Finds (usnews.com) 59
Long-time Slashdot reader schwit1 shared this article from HealthDay:
In earlier studies, patients have pegged CPR survival rates at between 19% and 75%. But the real rate of survival is about 12% for cardiac arrests that occur outside hospitals and between 24% and 40% for those that happen in the hospital, according to the report published online July 13 in the Emergency Medicine Journal.
For the new study, Bandolin's team surveyed 500 emergency department patients and their companions. Fifty-three percent said they had done or witnessed CPR, and 64% had taken a CPR course. Ninety-five percent said their main source of CPR information was television. About half said the success rate of CPR topped 75%. And nine out of 10 said they wanted to receive CPR if it was needed.
But only 28% had discussed CPR with a doctor, the investigators noted in a journal news release.
For the new study, Bandolin's team surveyed 500 emergency department patients and their companions. Fifty-three percent said they had done or witnessed CPR, and 64% had taken a CPR course. Ninety-five percent said their main source of CPR information was television. About half said the success rate of CPR topped 75%. And nine out of 10 said they wanted to receive CPR if it was needed.
But only 28% had discussed CPR with a doctor, the investigators noted in a journal news release.
CPR is better than doing nothing (Score:4, Informative)
I was ACLS certified before I retired, and I much preferred trying to revive a patient with a beating heart than one without one. Staying alive, staying alive!
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Hypothermia protocol was very popular just before I retired. Got a lot of push back from patient families though. They wanted blankets piled on because their loved one was cold.
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That's when you take your hands off and say "Ok, here's the deal. You let me save him or you get to save him. Make a choice quickly, every second matters. Now can I treat him right or the way you want it?"
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If you don't do even the 12% chance-of-success action, then you have a corpse cluttering up the sidewalk. And, as I remember, a very-recently widowed woman and an 8 year-old kid screaming at you. Memorable, that.
Re: CPR is better than doing nothing (Score:2)
CPR is the foundation of ACLS. But good ACLS is rapid defibrillation.
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True for v-tach and v-fib, but SVT and bradycardia require different interventions.
Poor outcomes even for survivors (Score:2)
Even those that survive CPR often have poor outcomes. They may be confined to a wheelchair, or suffer brain damage. Only a small percentage return to a normal life.
The belief that CPR is a magic solution comes from TV. Someone receives CPR, then gets up, defeats the bad guys, and a week later wins an Olympic gymnastics competition. In real life, that happens infrequently.
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Mass media needs to be held responsible for parroting false medical information by the way of fines and maybe even jail time. I'm sure a non-zero amount of people have overlooked a life-threatening situation because it's not like on TV.
Re:Poor outcomes even for survivors (Score:4, Insightful)
Mass media needs to be held responsible for parroting false medical information by the way of fines and maybe even jail time.
This is what I love about America: The eternal optimism that every problem can be solved by putting more people in jail.
Incarceration rates by country [wikipedia.org]
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This is very true.
Yeah, I've seen this almost first hand (Score:1)
I was not a direct witness to it, but a guy fell of a cliff on the beach near me. The first person on the scene was a young lady who valiantly administered CPR. When paramedics arrived, they were able to get him going again but I had a bad feeling about it. I remember walking up the path back to the parking lot thinking, "he's going up too". Sure enough, a small two-paragraph story in the paper the next day said he died at the hospital. Drinking and cliffs don't mix. He was in his early 20s.
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That actually depends on the trauma. Sometimes people's hearts stop suddenly with only a fairly modest chest impact, typically involving getting hit by a ball or similar. This phenomenon, called "commotio cordis", occurs when the chest gets hit at exactly the wrong point during the heart's cycle. In those cases, survival is about 25% if resuscitation is started within 3 minutes. That's not a great number, but it's a long way from "next to impossible". After three minutes, though, the survival rate dro
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which is why having AEDs everywhere sports are played is so crucial.
It's called a "defibrillator" for a reason. You cannot shock asystole. Your AED will not even go off. It works on ventricular fibrillation and some cases of tachycardia/torsades de pointes - ie where there is some degree of fibrillation...
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I didn't say you could shock asystole. That sentence was the only sentence in your post that I was not disagreeing with.
With AED? (Score:2)
Re:With AED? (Score:5, Insightful)
I had to do CPR a few years back, I just did the chest compression bit and took turns with a couple of work colleagues, I thought the guy had no chance but he did made a good recovery. The emergency services did turn up quick.
So, it might seem futile but it's worth a try.
And if you're the boss of someone who does CPR on someone that day, give them the rest of the day off.
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The one time I had to do CPR for real, the patient didn't survive,/quote>
That sucks, sorry for that. But if you hadn't done anything at all, the patient would have died for sure. You tried, and it could have made a difference. Sometimes it does, sometimes it doesn't.
My trainer told me one in ten will survive short term, and one in twenty long term. But if I'm dead already I'd rather have a one in twenty chance of surviving than no chance at all.
So please try again, next time. They are already dead and you could make all the difference.
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Re:With AED? (Score:4, Insightful)
This thread actually surprises me and has made me die inside a little.
I've done first aid training a number of times in a number of circumstances, I did it in the military, I did it as part of my rescue diver training, and I did it as part of recertification to be a first aider in a typical office scenario.
In each case the training was very different by people with very different backgrounds and with a very different focus - the military had a heavier focus on bullet wounds, tourniquets, heavy bleeding, and that sort of thing. Rescue diving had a heavy focus on drowning incidents, CO2 and Oxygen toxicity, and so forth. The office training was more concerned about burn, electric shocks, and heart attacks. But also, in every single one of those training sessions it was made clear to us that CPR doesn't have a high success rate, but AEDs are significantly more effective with many studies showing a survival rate as high as 50% when an AED is added into the equation.
I'm not having a pop at you for not knowing this - reading the summary and this thread it seems very few people that have done first aid training are aware of this, this is a revelation to me, I thought it was standard in first aid training across the globe. I'm amazed therefore at how many people are posting here with the implication that first aid courses aren't covering this rather important fact. We were always told to send someone immediately for an AED even if you end up not needing it for precisely this reason - it could be the difference between a 1 in 10 chance of saving someone and a 1 in 2 chance of saving someone.
CPR is nothing more than a last ditch effort, and any trainer teaching otherwise should be fired on the spot. You do it when the situation is bad enough to warrant it, when no other options are available, and you do it until professional medical support arrives or until the patient responds - it's hard, it's physically painful to do for real especially for any extended time, and the success rate is low, but most people would prefer you give them that chance no matter how small, and that's why we do it when no other option is available.
Don't feel bad that it failed for you - the odds were always stacked heavily against you - if anyone told you different they were being incredibly unfair and setting you up for that disappointment. You did the right thing and tried anyway and I hope if you need to you'd still try your best to do it again regardless of the previous outcome, because the hope is that sometime, maybe, just maybe, the odds are in your favour and you hit that 10% success rate and save a life.
In fact, the basis of pretty much all first aid is that it's best efforts, you're really just there to do what little you can to increase chances, you're not a medic, or a doctor and no one should expect you to be because you do not have those years of training and the equipment nor knowledge of how to use it that they have. The fact you tried something is really what matters, because that's something more than the vast majority of people would do and that makes you a good person even if your efforts ultimately failed. As the saying goes, "Imperfect care administered is better than perfect care withheld" - you tried to do something, and that's better than doing nothing because you were worried you wouldn't do it perfectly or get a perfect outcome - it's hard to make the situation worse when someone is literally minutes from death so it's better to do something than nothing, because giving them a +10% chance of survival is better than giving them a 0% chance of survival.
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Thanks for the kind words. I realize
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Make that 14. Duh.
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To be slightly pedantic, sometimes you have do CPR even when other options are available. In particular, if the patient doesn't have a shockable rhythm, you have to start with CPR first. But otherwise, yes.
Re:With AED? (Score:5, Informative)
Should we be doing CPR at all? (Score:2)
It is very hard to know whether a faint heart is beating or not. Thumbing on an unconcious person's chest when there heart is actually OK is not going to do them any good.
I had this experience a couple of years ago at a classical concert. Man in front of me went unconscious. I made space, got him to the ground. First question -- is he breathing? Again not easy to tell, it was at best shallow.
Fortunately a nurse was in the audience and took over after I called out. She put him on his side, and he soon
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YOU might do that, but I would not.
I had someone pass out on me in a concert. Got him to the ground, but hard to tell whether they were breathing let alone pulse. Fortunately I was saved by a nurse at the concert.
So for non-experts in non-medical situations, is the CPR likely to do more harm than good?
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Do how do you know they are "dead"? By asking them?
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Compare that 12% ... (Score:2)
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In hospital chances are better (Score:2)
I knew the numbers for CPR but one question was lingering: You'd hope that maybe with better training people would be able to increase the chance of survival so it becomes closer to hospital numbers.
Now,slightly on a tangent but if anyone wants to watch fascinating and educational stories about rapid response teams saving people against the odds, I really recommend the presentation(s) of the late John Hinds, a flying doctor at the Manx Tourist Trophy for motorbikes.
Hmmm... (Score:2)
And nine out of 10 said they wanted to receive CPR if it was needed.
12% chance or 0%? I'd so hate to put someone out...
CPR Is better than nothing! Indeed! (Score:3, Interesting)
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I'm trained in CPR, the survival rates are made very clear: It works well in some medical situations. It only works if administered quickly. The odds of success increase a shitton if you have access to an AED.
There's a lot of misconceptions around it and what it does. I blame Baywatch and action movies where people don't come back from CPR but then do come back when the actor cries and punches the corpse in the chest.
How many false positives? (Score:2)
How many unconscious people get seriously injured or killed because someone though their heart had stopped and pumped on it?
It is not at all easy to tell.
Re:How many false positives? (Score:4, Informative)
Firstly it's quite hard to counteract a beating heart with CPR to the point where you kill someone. Secondly no one trained in CPR cares about the heart. The only thing you're asked to check is for breathing.
If conscious > talk to victim put in recovery position and wait for ambulance.
If breathing > put in recovery position and wait for ambulance.
If not breathing > start CPR while waiting for ambulance. If the persons heart is beating, it won't beat much longer anyway unless you can get breathing back.
One of the key parts of survival is early administration. Survivability goes up when people don't fumble around trying to take a pulse.
Sssshhhhh... (Score:5, Insightful)
This is by design, if people knew the odds of CPR saving someone they wouldn't get training or attempt CPR, which would drop the survival rate of people who might benefit from CPR from 12% to a big fat zero.
Just a few weeks ago a friend saved his friend's life when he collapsed out on a mountain bike trail. He came out of it with a bunch of broken ribs (a sign of doing it right) but was fine otherwise.
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Sorry, but no. A broken rib is not a sign that it was done right. It can happen as a side effect of CPR but it's far from required. It's only something you accept as a possibility because healing ribs is easier than fixing a damaged brain.
Was this unexpected? (Score:3)
Of course does it make people believe it works well when all they know about it comes from movies and TV shows. Almost every movie, which features CPR, shows a 100% survival rate. There people simply bounce back to 120% - all thanks to the movie ratings!
The list of traumatic injuries that gets downplayed on TV and movie is endless. Only people unfortunate enough to make the real experience, and fortunate enough to survive it, can tell the truth ...
yup... (Score:2)
A family member is a retired firefighter.
I asked him about CPR.
Throughout his entire career, he only saw CPR work once to revive someone.
It mostly just buys you a few minutes of staying alive before the paramedics to arrive.
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Most of the time these days, you should use an AED to do the same thing. The only time it's appropriate is if you don't have an AED and you are certain that the person is in v-fib. If a person is in a shockable rhythm, either approach will likely work; if the person isn't, neither will. But an AED has sensors that can immediately tell you if the heart is in a shockable rhythm, whereas one's finger on someone's carotid likely can't.
You're still a lot better off with CPR (Score:5, Informative)
So if you do the math (going with 43% chance of CPR, 11% overall survival rate, and 2.5 increase in odds of survival), then (1-0.43)x + 0.43*2.5x = 0.11. 1.645x = 0.11. x = 0.067
So yeah it's lower than most people think. But your chances of surviving are still a lot better with CPR.
Survival rates? (Score:2)
The other thing that makes a difference (Score:3)
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Most people don't do it right (Score:2)
Don't ask EMTs about it (Score:2)
I volunteered for an ambulance service and learned that you just do not ask EMTs about their CPR experiences.
It's depressing how few people, if any, they have been able to save.
Better than 0% (Score:2)
If given a 12% chance or certain death, what're most people going to pick?
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That's not the point.
You see someone doing CPR on your father and you think "This is just like the movies, he stands a good chance of popping back to life."
No, he doesn't. Better than nothing, but chances are he's going to be dead, or even brain-damaged if it's not being done by a professional or goes on for too long.
"Too long", incidentally, is the few minutes for a defib to be found and used. They aren't going to be able to do it all the way back to the hospital and then save him.
Chances are, when you s
CPR is not for revival, it's for preservation (Score:2)
When attending a first aid training I was told that CPR aim is to prevent the heart from completely stopping while the defibrillator is on the way.
Sometimes miracles happen and the heart can restart beating normally but most of the time performing CPR simply keeps it fibrillating and circulates the blood.
For that reason no matter how long, You have to continue either till You can confirm the heartbeat and breathing is back (miracle) or the professional rescuers take over, even if You do it wrong it's bette
The main reason (Score:2)
so low it that in the vast majority of heart attack cases he is called on,
the patient is already dead. But he has to keep
trying until a doctor tells him it is OK to quit.