Cardiopulmonary resuscitation, commonly known as CPR, is a classic element of first aid. This method combines rescue breathing, chest compressions, and oftentimes electric shock delivered using a defibrillator. The aim of CPR is to start a heart that has stopped beating and to restore breathing (which in turn allows oxygen to reach the brain). CPR saves livesthere’s no doubt about thatbut it does not come without a certain degree of risk.
Originally developed during the Korean War as an emergency procedure for soldiers injured on the battlefield, CPR may not be the most appropriate choice for every patient. CPR often results in broken ribs and can also cause a collapsed lung or punctured spleen. Even among generally healthy adults, only 15-20% of those who receive emergency CPR will survive to be discharged from the hospital. The unfortunate truth is that those numbers are dramatically lower for the elderly, especially those who suffer from more than one ailment and those beyond the age of 75.
Physicians, patients, and the family members of elderly loved ones are oftentimes divided about whether or not to administer CPR, or to opt instead for comfort care. Comfort care focuses on relieving pain and discomfort, rather than prolonging life. There is no one right answer to this question. Instead, open dialogue is the best way to handle these difficult choices, especially when the conversation occurs before an emergency situation arises.
Below are some questions to consider when discussing whether CPR or comfort care is best for your loved one.
Are any of the following truean answer of yes indicates a higher chance of survival with CPR:
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patient is under the age of 75;
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patient is generally capable of performing routine self-care;
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patient was previously diagnosed with an abnormal heart rhythm;
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patient is experiencing respiratory arrest only (there is still a pulse);
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patient has no serious preexisting medical conditions?
Are any of the following truean answer of yes indicates a lower chance of survival with CPR and comfort care may be a good alternative:
- patient is over the age of 75;
- patient is mostly dependent on others for care;
- patient suffers from one or more preexisting medical condition;
- patient has a terminal illness;
- patient has a history of bone density loss?
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Of course, it is important to consult with a trusted physician when discussing how to best care for your loved ones. Many families also choose to involve a member of the clergy. This can keep anxiety levels at a minimum should your loved one require emergency attention.
If you have not discussed preferences with your loved one and you find yourself in a situation that demands quick action, do your best to survey the patient. This chart is a helpful reminder of what you should look for and what you should do based on your observations.
If there is an elderly loved one in your life, you may wish to enroll in an online Basic Life Support (BLS) course. Doing so will equip you with the knowledge and skills to administer CPR and to improve your loved one’s likelihood of having a positive outcome. I received my certification when my mother-in-law became ill and knowing that I was prepared in the event of an emergency helped me to relax and focus on providing her with the best care possible. BLS certification endorsed by the American Heart Association is available from acls.net.
Shanon Raynard has worked in emergency medicine for eight years. She believes that access to better information leads to better, healthier lives.