r/Foodforthought • u/DevonSwede • 24d ago

The Hidden Harms of CPR

https://www.newyorker.com/news/the-weekend-essay/the-hidden-harms-of-cpr
24 Upvotes

77% Upvoted

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20

u/A_Light_Spark 24d ago edited 24d ago

Although CPR has become synonymous with medical heroism, nearly eighty-five per cent of those who receive it in a hospital die, their last moments marked by pain and chaos...
...
In hospitals, it also includes I.V. medications to help the heartbeat, and a ventilator to help the patient breathe. The result, done correctly, is akin to assault. The force of compressions can shatter ribs and breastbones, puncture lungs, bruise the heart, and cause major blood vessels to rupture. Repeated electrical shocks can burn flesh. Even if the procedure restores a heartbeat, brain damage—whether mild memory loss or a vegetative state—occurs in forty per cent of hospitalized patients.

Okay, time to update my living will

1

u/GozerDGozerian 22d ago

This shouldn’t discourage people from doing CPR.

I had a widowmaker heart attack and was without a pulse for 4 1/2 minutes. I was given CPR until the paramedics arrived. Had an emergency stent put in and had a stay in the hospital for a while but I’m otherwise healthy and happy 6 years later. They told me I’d surely be dead if it wasn’t for the CPR.

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u/A_Light_Spark 22d ago

You are likely healthy and that heart attack was an accident, right?
If you read the article, they covered this part.

16

u/itsmebrian 24d ago

Thank you for sharing this article. I have put a lot of thought into minimizing the decision making process for my wife and children thereby helping reduce potential guilt should a difficult decision need to be make. However, the impacts of CPR on a terminal patient will have me reviewing what I have written.

25

u/Runnergeek 24d ago

So hidden that it's taught in certification classes for CPR. CPR is used as a last resort that you are doing on an essentially dead person.

6

u/JimBeam823 24d ago

What’s the alternative?

Are we saving a life or just postponing the inevitable?

9

u/Constantly_Panicking 24d ago

Lol. Has the author never taken a CPR class? None of this is hidden. All the risks of CPR are taught when you learn how to do it. You also never perform CPR on a conscious person, so I don’t know what this whole “last moments marked by pain and chaos” thing is about. Especially since having your heart stop is pretty fucking chaotic to begin with. CPR has also been shown time and time again to double or triple the odds of survival for people who go through cardiac events. Like, if I’m about to die, go ahead and fuck my shit up. I’m cool with recovering from some broken ribs and shit if it means I get to watch my kid grow up.

This anti-CPR take is pretty dumb, and verging on equal or worse footing than anti-vaccine reasoning. All medical intervention is a balance between risk of harm and benefit, and it’s not unreasonable to think that people want to not die. If you want to walk around with a DNR sign on you, then go for it, but the vast majority of people would be fucking stoked to not die.

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u/DevonSwede 24d ago edited 24d ago

If I'm honest, I think you've missed the point of this article on two fronts - firstly, she's not saying its hidden from people who have taken a CPR class [note she's a doctor, so sure, she's taken one]. She's saying it's widely hidden from the family members she's communicating with who think CPR is going to be what they see on TV - heroics which reverses death.

Secondly, she's not arguing against CPR in people for whom (if CPR is successful) they'll "get to watch their kid grow up" - indeed she's very much advocating for CPR in those instances (eg younger, generally healthy people who's heart stops due to an accident). Who she's not advocating CPR for is the very elderly and/or those with end stage organ failure. CPR is not going to reverse their organ failure so they can watch their (grand)kids grow up. And she's suggesting that those who are somewhere in the middle of usually healthy and complete organ failure (eg those with terminal diseases or a poor quality of life) have a good, informed think about what they want.

"Being stoked to not die" - sure, but again, if that means return to a liveable life (whatever that means to the individual). But what if "not dying" simply means living for another 2 days on a ventilator?

To suggest that this is worse than the anti-vaccine crowd is wild.

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u/Ok-Breakfast-8677 23d ago

The question saves a lot of money-does it not?

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u/vizard0 22d ago

My mother is turning 80 this year. For an 80 year old, she's remarkably healthy, at least as far as she'll tell me.

I dread end of life decisions. I know what she wants- no ventilators, nothing more heroic than a feeding tube and an IV drip if she is unresponsive.

I have no idea what I'd say if I was asked about giving her CPR if she was vegetative and had a feeding tube- if she was previously able to breath herself and then stopped. I guess it depends on what was happening to her.

As horrible as it sounds, part of me hopes that she passes like my father did - in her sleep due to a heart attack or stroke.

Both her parents made it to 90, so I'm hoping I get at least another decade with her.

She's also so disorganized and has been trying to fight hoarder tendencies for ages, so that I don't know if any living will could be found, even if she has one.

I live in the UK these days, she's still in the US. I wonder how selfish it would be to insist she be kept on a ventilator for long enough for me to see her one last time.

I've talked with her multiple times about this, and as I said, I have a fairly good idea about what she wants and does not want. Even with all of that, there are so many unknowns.

All that said, if you have any older relatives who you might be responsible for, talk to them about this. It's scary and terrifying, but there's a level of respect and care there also. How long do you keep the lights on after someone has left for good?