To CPR or Not To CPR? 
Author Message
 To CPR or Not To CPR?

To make a long story short, my elderly father is quite weak, has
Alzheimer's and congestive heart failure, and lives in a convalescent
home. He desires a full code advanced directive for CPR should
circumstances warrant, largely because that's what I want.

In the event of circumstances needing cpr, one of three things can
happen, depending on the instructions of the advanced directive:
1. if the advanced directive prohibits cpr, none is given and the
elderly person likely dies;
2. if the advanced directive orders cpr be given, then the elderly
person either doesn't revive or does revive, probably with broken
ribs, as I understand it, which quite likely will eventuate death
while greatly diminishing quality of life.

My reasoning is that if the person would have died anyway without cpr,
nothing is lost in the attempt to revive with cpr, and successful
application of the procedure means that there is the chance that ribs
will not be broken and the person will live, or if they are broken and
death ensues from related complications, then that is what would have
happened had cpr not been administered, and no one is out anything, as
it were, for the attempt except perhaps in the context of quality of
life.

The entire medical community where I live is unanimous in strongly
discouraging my position, given my father's age, but they will abide
by our wishes.

My first question is this:
In order to spare everyone involved the necessity of following what
seems to be an undesirable procedure in such a case as I've described
above, why don't nursing homes keep onhand the electric shock
cardio-resusitating equipment that would avert the need for applying
cpr in the first place?

My second question is:
Is it true that the vast majority of elderly people given cpr
experience broken ribs or bones from its administration that eventuate
death?

This issue has haunted the family for over a year. Thank you for your
response.



Sun, 28 Nov 2004 05:49:30 GMT
 To CPR or Not To CPR?

Quote:

> To make a long story short, my elderly father is quite weak, has
> Alzheimer's and congestive heart failure, and lives in a convalescent
> home. He desires a full code advanced directive for CPR should
> circumstances warrant, largely because that's what I want.

> In the event of circumstances needing cpr, one of three things can
> happen, depending on the instructions of the advanced directive:
> 1. if the advanced directive prohibits cpr, none is given and the
> elderly person likely dies;
> 2. if the advanced directive orders cpr be given, then the elderly
> person either doesn't revive or does revive, probably with broken
> ribs, as I understand it, which quite likely will eventuate death
> while greatly diminishing quality of life.

> My reasoning is that if the person would have died anyway without cpr,
> nothing is lost in the attempt to revive with cpr, and successful
> application of the procedure means that there is the chance that ribs
> will not be broken and the person will live, or if they are broken and
> death ensues from related complications, then that is what would have
> happened had cpr not been administered, and no one is out anything, as
> it were, for the attempt except perhaps in the context of quality of
> life.

> The entire medical community where I live is unanimous in strongly
> discouraging my position, given my father's age, but they will abide
> by our wishes.

> My first question is this:
> In order to spare everyone involved the necessity of following what
> seems to be an undesirable procedure in such a case as I've described
> above, why don't nursing homes keep onhand the electric shock
> cardio-resusitating equipment that would avert the need for applying
> cpr in the first place?

Good question.  They should.

Quote:

> My second question is:
> Is it true that the vast majority of elderly people given cpr
> experience broken ribs or bones from its administration that eventuate
> death?

Not true.

--
Dr. Andrew B. Chung, MD/PhD
Atlanta Cardiologist
http://www.heartmdphd.com



Sun, 28 Nov 2004 06:44:36 GMT
 To CPR or Not To CPR?
What is your father's age?
As far as the "electric shock cardio-resusitating equipment", they
definitely should, but there are only a couple rhythms those recognize.
Otherwise you'll be doing CPR, and even if it is a shockable rhythm, you'll
be doing CPR in some of the meantimes.
The broken ribs depend on a lot of things.  I had a 300+lb partner who broke
the ribs of a <100lb frail, elderly female.  I haven't broke any ribs the
two or three times I've done CPR.  It would depend a lot on your father's
build and bone "health".

--
John
Webmaster
www.FileFlash.com
www.fileflash.com/reebok
AIM: reebokEMT


Quote:
> To make a long story short, my elderly father is quite weak, has
> Alzheimer's and congestive heart failure, and lives in a convalescent
> home. He desires a full code advanced directive for CPR should
> circumstances warrant, largely because that's what I want.

> In the event of circumstances needing cpr, one of three things can
> happen, depending on the instructions of the advanced directive:
> 1. if the advanced directive prohibits cpr, none is given and the
> elderly person likely dies;
> 2. if the advanced directive orders cpr be given, then the elderly
> person either doesn't revive or does revive, probably with broken
> ribs, as I understand it, which quite likely will eventuate death
> while greatly diminishing quality of life.

> My reasoning is that if the person would have died anyway without cpr,
> nothing is lost in the attempt to revive with cpr, and successful
> application of the procedure means that there is the chance that ribs
> will not be broken and the person will live, or if they are broken and
> death ensues from related complications, then that is what would have
> happened had cpr not been administered, and no one is out anything, as
> it were, for the attempt except perhaps in the context of quality of
> life.

> The entire medical community where I live is unanimous in strongly
> discouraging my position, given my father's age, but they will abide
> by our wishes.

> My first question is this:
> In order to spare everyone involved the necessity of following what
> seems to be an undesirable procedure in such a case as I've described
> above, why don't nursing homes keep onhand the electric shock
> cardio-resusitating equipment that would avert the need for applying
> cpr in the first place?

> My second question is:
> Is it true that the vast majority of elderly people given cpr
> experience broken ribs or bones from its administration that eventuate
> death?

> This issue has haunted the family for over a year. Thank you for your
> response.



Sun, 28 Nov 2004 06:57:17 GMT
 To CPR or Not To CPR?

Quote:

>To make a long story short, my elderly father is quite weak, has
>Alzheimer's and congestive heart failure, and lives in a convalescent
>home. He desires a full code advanced directive for CPR should
>circumstances warrant, largely because that's what I want.

Do you want what he would have wanted, when he didn't have Alzheimer's
disease? Is this what you'd want for yourself if you were in his position?
How do you want to end your life?

Quote:
>In the event of circumstances needing cpr, one of three things can
>happen, depending on the instructions of the advanced directive:
>1. if the advanced directive prohibits cpr, none is given and the
>elderly person likely dies;
>2. if the advanced directive orders cpr be given, then the elderly
>person either doesn't revive or does revive, probably with broken
>ribs, as I understand it, which quite likely will eventuate death
>while greatly diminishing quality of life.

Broken ribs are hardly the worst that can happen. The worst is more brain
damage and/or a long stint on a ventilator in an ICU before eventual death.
Young people take periods of no {*filter*} flow to the brain better than old
people with dementia.

Quote:
>My reasoning is that if the person would have died anyway without cpr,
>nothing is lost in the attempt to revive with cpr, and successful
>application of the procedure means that there is the chance that ribs
>will not be broken and the person will live, or if they are broken and
>death ensues from related complications, then that is what would have
>happened had cpr not been administered, and no one is out anything, as
>it were, for the attempt except perhaps in the context of quality of
>life.

Well, true, you're not out anything if you're not the one who spends his
last days on a ventilator, and you're not the one paying for it.

Quote:
>My first question is this:
>In order to spare everyone involved the necessity of following what
>seems to be an undesirable procedure in such a case as I've described
>above, why don't nursing homes keep onhand the electric shock
>cardio-resusitating equipment that would avert the need for applying
>cpr in the first place?

It wouldn't.  Most of the CPR applied to elderly people that ends up doing
any good (i.e. with somebody making it out of the hospital), is CPR that was
applied for a respiratory, not a cardiac arrest. Often the heart never does
quite stop, so defibrillators do no good. Even in primary cardiac arrest
(V-fib and the like) you only have about a minute before defibrillation
doesn't do any good without CPR first. The reason is that a heart without
coronaries full of oxygenated {*filter*} cannot be defibrillated, and you need
CPR to get some oxygen into the coronaries first.

This is not to say that defibrillators in nursing homes aren't a good idea.
Just don't get the idea that they would replace CPR. They would supplement
CPR only.

Quote:
>My second question is:
>Is it true that the vast majority of elderly people given cpr
>experience broken ribs or bones from its administration that eventuate
>death?

No, they probably don't-- the broken rib thing is a scare story that they
use to shake some sense into families who think that CPR is magic. Doctors
and nursing homes know it isn't, and that it IS mostly futile, but they have
a hard time getting the idea across without a good metaphor. Crunching ribs
in an elderly person is a good metaphor to explain the problem to the
general public, and indeed, it sometimes happens (I've done it, and the
sensation sticks with you). But it's not the main problem.

The main problem is that the fraction of elderly people getting CPR in an
institutional setting who end up getting out of the hospital and back to the
institution again, is tiny. Something like 5% (though of course it varies
widely due to many variables).

Quote:
>This issue has haunted the family for over a year. Thank you for your
>response.

You're welcome.

SBH

--
I welcome email from any being clever enough to fix my address. It's open
book.  A prize to the first spambot that passes my Turing test.



Sun, 28 Nov 2004 07:15:44 GMT
 To CPR or Not To CPR?

:To make a long story short, my elderly father is quite weak, has
:Alzheimer's and congestive heart failure, and lives in a convalescent
:home. He desires a full code advanced directive for CPR should
:circumstances warrant, largely because that's what I want.

Why do you want a full code performed on your weak, elderly father who
has  Alzheimer's, CHF, and is living in a nursing home?   Is there a
particular reason you want to extend his life, and in what manner
would you like him to die?   In other words, would you rather he die a
drawn out death from cancer or kidney disease or some other chronic
illness that could be much more painful than his present condition?
What sort of death would you consider dignified and desirable?   I'm
not asking these questions to be mean, just wondering if you've
thought about what would be best for him.
Becky



Sun, 28 Nov 2004 07:28:08 GMT
 To CPR or Not To CPR?

Quote:

> To make a long story short, my elderly father is quite weak, has
> Alzheimer's and congestive heart failure, and lives in a convalescent
> home. He desires a full code advanced directive for CPR should
> circumstances warrant, largely because that's what I want.

I think you need to carefully examine what you want and why you want it.
Whatever you want, you need to make that choice based on facts and realistic
expectations, and I'm not sure you're armed with facts and realistic
expectations at this point.

Quote:
> In the event of circumstances needing cpr, one of three things can
> happen, depending on the instructions of the advanced directive:
> 1. if the advanced directive prohibits cpr, none is given and the
> elderly person likely dies;
> 2. if the advanced directive orders cpr be given, then the elderly
> person either doesn't revive or does revive, probably with broken
> ribs, as I understand it, which quite likely will eventuate death
> while greatly diminishing quality of life.

Broken ribs are a possibility, but not likely.  Whoever told you that is
wrong, or perhaps you misunderstood.  CPR, when performed correctly, does not
usually cause broken ribs.  But even if it does, this is the last complication
you should be worried about.  The complication you *should* be worried about
is your father spending his last days in a vegetative state in an ICU,
attached to a ventilator, connected to IV lines, being tube fed, only to die
within days of infection, ARDS, and multiple organ failure.  The absolute
worst possibility is the same scenario, but one where he is conscious and
aware of his gruesomely unpleasant predicament and the misery that goes with
it.

Quote:
> My reasoning is that if the person would have died anyway without cpr,
> nothing is lost in the attempt to revive with cpr, and successful
> application of the procedure means that there is the chance that ribs
> will not be broken and the person will live, or if they are broken and
> death ensues from related complications, then that is what would have
> happened had cpr not been administered, and no one is out anything, as
> it were, for the attempt except perhaps in the context of quality of
> life.

I'm afraid you may have an unrealistic expectation of what your father's life
will be like in the event he is successfully resuscitated.  Ignore what you
see on TV.  It is not reality.  If you expect him to wake up and be his old
self, I'm afraid that's extremely unlikely.  If he wakes up at all, he will be
a very, very sick man, and it's unlikely he will ever leave the hospital.  If
this were not so, your logic would be valid, but I'm afraid it is so.  Yes,
miracles are possible, but the price of not getting a miracle is heavy.

Quote:
> The entire medical community where I live is unanimous in strongly
> discouraging my position, given my father's age, but they will abide
> by our wishes.

They are discouraging you because they know his condition and they've seen it
before - far too many times.  Given your father's age and medical condition, I
would discourage it as well.  If it were me in your father's situation, I
would *beg* you to choose the DNR option (DNR = do not resuscitate).  Talk to
any medical person who has seen this before and I think you'll get the same
answer.

Quote:
> My first question is this:
> In order to spare everyone involved the necessity of following what
> seems to be an undesirable procedure in such a case as I've described
> above, why don't nursing homes keep onhand the electric shock
> cardio-resusitating equipment that would avert the need for applying
> cpr in the first place?

Some do, but far too many don't.  The answer is simple and ugly: money.  Yes,
it's shameful.

However, the defibrillator you're speaking of does *not* eliminate the need
for CPR.  If your father doesn't have DNR orders in place when his heart
stops, CPR *will* be initiated.  The nursing staff will initiate it, and then
they will call 911.  Someone like me will arrive in an ambulance.  We will
apply a defibrillator, stick a tube down his mouth and into his trachea, and
insert IV lines into his veins.  We will continue CPR, defibrillate him,
inject him with {*filter*}, and force air into his lungs through the tracheal
tube.  We will continue this for some number of minutes until either we
succeed in restoring a pulse, or we determine that further efforts are
futile.  Either way, it's not pretty.  Every time I go through these motions
on someone like your father, I silently ask him to forgive me.  I would not
wish this on my father, or anyone else I cared about.

Quote:
> My second question is:
> Is it true that the vast majority of elderly people given cpr
> experience broken ribs or bones from its administration that eventuate
> death?

Like I said before, the vast majority do *not* die from complications of
broken ribs.  They die from complications of their heart stopping, which
causes their brain and other vital organs to be deprived of oxygen and toxic
wastes to accumulate and poison them.  To die of cardiac arrest is not ugly -
it is probably the most humane, "pleasant" death there is.  But to die of the
complications of cardiac arrest undone by modern medicine *is* ugly, and one
of the least humane, least "pleasant" deaths there is.  I would not wish it on
anyone.

Quote:
> This issue has haunted the family for over a year. Thank you for your
> response.

I know this is a difficult decision for you, probably one of the most
difficult you'll ever face.  I urge you to take his wishes to heart and set
yours aside.  If he's too far into Alzheimers to make informed decisions, then
go on what you think he would have wanted before the Alzheimers.  It's his
life, not yours.  I also urge you to take the medical staff's recommendations
to heart.  They know his condition, and they've seen it before.


Sun, 28 Nov 2004 08:07:45 GMT
 To CPR or Not To CPR?

Quote:
> To make a long story short, my elderly father is quite weak, has
> Alzheimer's and congestive heart failure, and lives in a convalescent
> home. He desires a full code advanced directive for CPR should
> circumstances warrant, largely because that's what I want.

This is one of those curly ethical questions.

My answer to the question, among other things, is that autonomy is
important.  It's up to your dad what happens if he needs CPR.  If he wants
CPR, he gets CPR.  Whether he's 25 or 105.  You can't pass judgement on a
guy's intrinsic value based on whether he requires nursing.

Quote:
> 2. if the advanced directive orders cpr be given, then the elderly
> person either doesn't revive or does revive, probably with broken
> ribs, as I understand it, which quite likely will eventuate death
> while greatly diminishing quality of life.

If you're in a position where you desperately need CPR, broken ribs are the
least of your concerns.

CPR is much less effective in the long run than the medical profession will
let on to.  The probability of getting more spontaneous heart beats after
heart attacks requiring CPR in intensive care units is in the order of 70%.
On the street with untrained operators it's like 2%.  But the long-term
survival is appalling in both cases.

Quote:
> will not be broken and the person will live, or if they are broken and
> death ensues from related complications

After CPR, death will occur because of whatever made them need CPR.  For a
person's heart to stop beating is catastrophic in and of itself, broken
ribs or not.

Quote:
> The entire medical community where I live is unanimous in strongly
> discouraging my position, given my father's age, but they will abide
> by our wishes.

Your father's age has nothing at all to do with his quality of life or his
right to have CPR.  I'd make sure that if a CPR directive is given, that it
is followed properly.  Medical people sometimes engage in pseudo-codes,
where they only pretend to resuscitate someone.  Either they're going to do
it or not.  Nothing would make the sue the Bejesus out of a
hospital/nursing home, and hunt the deregistration of her carers, like
finding out that they had failed to properly resuscitate my mother.

Quote:
> In order to spare everyone involved the necessity of following what
> seems to be an undesirable procedure in such a case as I've described
> above, why don't nursing homes keep onhand the electric shock
> cardio-resusitating equipment that would avert the need for applying
> cpr in the first place?

In Australia, I think it would be mandatory to have a 'crash cart' with
defibrillator.

CPR and defibrillators are used in two different circumstances.  CPR is
when the heart stops beating entirely (and won't defibrillate).

Quote:
> Is it true that the vast majority of elderly people given cpr
> experience broken ribs or bones from its administration that eventuate
> death?

I seem to remember that the incidence of broken ribs is something like 50%.
But it's not the broken ribs that cause death.  Even if broken ribs
occurred, if he were in pain, he'd be put on morphine (which might kill him
anyway).

Quote:
> This issue has haunted the family for over a year.

Then the answer should be pretty clear to you.  I think you're feeling
guilty because you're about to provide a no-resuscitate order.  Why would
you feel guilty about doing all that you can?

---

Checked by AVG anti-virus system (http://www.grisoft.com).
Version: 6.0.370 / Virus Database: 205 - Release Date: 6/5/2002



Sun, 28 Nov 2004 09:33:30 GMT
 To CPR or Not To CPR?


Quote:
> My first question is this:
> In order to spare everyone involved the necessity of following what
> seems to be an undesirable procedure in such a case as I've described
> above, why don't nursing homes keep onhand the electric shock
> cardio-resusitating equipment that would avert the need for applying
> cpr in the first place?

One word: Money
LifePak12 costs (i think) around $AUS12, 000 (pretty sure of this).  Image
the cut backs in quality of patient care, staffing, facilities etc. if the
often poorly government- supported (hah! there's an oxymoron!) aged care
facilities had to fork out for this.  In an ideal world, yes, every nursing
home would have one, while we're at it we'd improve the working and living
conditions. However this is not an ideal world and this ain't an ideal
solution.
'Fraid that's what it comes down to in our society: Money


Sun, 28 Nov 2004 10:00:49 GMT
 To CPR or Not To CPR?


Quote:
> To make a long story short, my elderly father is quite weak, has
> Alzheimer's and congestive heart failure, and lives in a convalescent
> home. He desires a full code advanced directive for CPR should
> circumstances warrant, largely because that's what I want.

First of all, what you and your family want should be irrelevant. You should
do what he wants. It is his life.

Secondly, you seem to assume that there are only two possible outcomes,
either he lives as he is or he dies. So why not take a shot at life? The
answer is because there are more than two outcomes. The chances that he
would survive a full arrest in the nursing home are slim. I think Steve's 5%
quote is about right and, if anything, optimistic. In the unlikely event
that he does survive the chances that he will retain his current level of
functioning are much slimmer. More than likely he would end up a bedbound
vegetable with little or no cognitive function. This is the reason not to do
the CPR. Most of the survivors would be better off dead.

--
CBI, MD

"Believe those who are seeking the truth; doubt those who find it."
-Andre Gide



Sun, 28 Nov 2004 10:28:48 GMT
 To CPR or Not To CPR?
Quote:

> To make a long story short, my elderly father is quite weak, has
> Alzheimer's and congestive heart failure, and lives in a convalescent
> home. He desires a full code advanced directive for CPR should
> circumstances warrant, largely because that's what I want.

> In the event of circumstances needing cpr, one of three things can
> happen, depending on the instructions of the advanced directive:
> 1. if the advanced directive prohibits cpr, none is given and the
> elderly person likely dies;
> 2. if the advanced directive orders cpr be given, then the elderly
> person either doesn't revive or does revive, probably with broken
> ribs, as I understand it, which quite likely will eventuate death
> while greatly diminishing quality of life.

> My reasoning is that if the person would have died anyway without cpr,
> nothing is lost in the attempt to revive with cpr, and successful
> application of the procedure means that there is the chance that ribs
> will not be broken and the person will live, or if they are broken and
> death ensues from related complications, then that is what would have
> happened had cpr not been administered, and no one is out anything, as
> it were, for the attempt except perhaps in the context of quality of
> life.

> The entire medical community where I live is unanimous in strongly
> discouraging my position, given my father's age, but they will abide
> by our wishes.

> My first question is this:
> In order to spare everyone involved the necessity of following what
> seems to be an undesirable procedure in such a case as I've described
> above, why don't nursing homes keep onhand the electric shock
> cardio-resusitating equipment that would avert the need for applying
> cpr in the first place?

This is largely an issue of money.  It would require additional money
to purchase the required equipment.  In addition, it would require
additional training for the medical staff who would have to maintain
this certification.

Quote:
> My second question is:
> Is it true that the vast majority of elderly people given cpr
> experience broken ribs or bones from its administration that eventuate
> death?

I will have to disagree with the other two posters.  No offense to
them but after 13 years of being a paramedic, I have seen lots of
patients get broken ribs from CPR, even if the technique was perfect.
A lot does depend on the patients physical characteristics and the
length of the resuscitation effort.

Quote:
> This issue has haunted the family for over a year. Thank you for your
> response.

I am glad to see you make a stand with regard to the issue of the
advanced directive.  Just a couple of thoughts though.

First, make sure it is a legally binding document in accordance with
your state laws. Your state department of health should be able to
provide you with guidance.

Secondly, it should be specific as to what level of resuscitation care
is being witheld. CPR only, defibrillation only, medications only, no
intubation, etc.  This may be regulated by state/local laws.

Finally, I would suggest that you discuss the issue of how the
facility will respond should your father arrest.  As you have already
noted, these facilities do not have advanced resuscitation equipment
on hand. The standard response of many facilities is to call 911.
When we (the paramedics) show up, if they do not have the original,
legally binding DRN (Do Not Resuscitate) order then we are often
required to begin full resusciation procedures.  Again this varies
highly state to state.  If the facility does utilize the local 911 EMS
system, you may wish to contact them and if requested, provide them
with a copy of the DNR order.  They may also be able to provide
information regarding its validity.

I understand what a difficult time for you this must be.  I wish you
and your father well.

Chuck, EMT-P, I/C
EMS/BCLS/ACLS Inst.



Sun, 28 Nov 2004 11:19:21 GMT
 To CPR or Not To CPR?


Quote:

> I will have to disagree with the other two posters.  No offense to
> them but after 13 years of being a paramedic, I have seen lots of
> patients get broken ribs from CPR, even if the technique was perfect.
> A lot does depend on the patients physical characteristics and the
> length of the resuscitation effort.

This would be my experience as well. Remember that you are compressing about
once per second over several (at least) minutes. Even if nearly all
compressions are right on it would be nearly impossible not to throw a few
ones in that are too deep. Some elderly people have very brittle bones and
will experience fractures even when the compresssions are appropriate. I
would say that I have broken ribs most of the time if not every time.

--
CBI, MD



Sun, 28 Nov 2004 11:43:59 GMT
 To CPR or Not To CPR?

Quote:
> This would be my experience as well. Remember that you are compressing
about
> once per second over several (at least) minutes. Even if nearly all
> compressions are right on it would be nearly impossible not to throw a
few
> ones in that are too deep.

I've been told by a professor of emergency medicine that if ribs are
broken, it's a sign of good technique.  Apparently one of the most common
errors in delivering CPR is that people don't push hard enough.  Better
break a few ribs than to stuff it up.

Quote:
> will experience fractures even when the compresssions are appropriate. I
> would say that I have broken ribs most of the time if not every time.

Again, broken ribs are the least of my worries.  You can't fail to
resuscitate someone because of broken ribs.  I'm a 24 year old guy - would
you fail to resuscitate me because of the potential for broken ribs?
Jesus!  If not, then don't apply the same test to an old guy.

---

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Version: 6.0.370 / Virus Database: 205 - Release Date: 6/5/2002



Sun, 28 Nov 2004 17:14:59 GMT
 To CPR or Not To CPR?


Quote:




>>> I will have to disagree with the other two posters.  No offense to
>>> them but after 13 years of being a paramedic, I have seen lots of
>>> patients get broken ribs from CPR, even if the technique was
>>> perfect. A lot does depend on the patients physical characteristics
>>> and the length of the resuscitation effort.

>>This would be my experience as well. Remember that you are compressing
>>about once per second over several (at least) minutes. Even if nearly
>>all compressions are right on it would be nearly impossible not to
>>throw a few ones in that are too deep. Some elderly people have very
>>brittle bones and will experience fractures even when the
>>compresssions are appropriate. I would say that I have broken ribs
>>most of the time if not every time.

> You are a {*filter*} psychopath.

No, CBI is a realist and will try to cheat death.  I would want to have CBI
at my side than a quitter, broken ribs and all.

r

--
"I will not be pushed, filed, stamped, indexed, briefed, de-briefed, or
numbered...My life is my own."

"I am not a number.  I am a free man."
No. 6



Sun, 28 Nov 2004 17:34:00 GMT
 To CPR or Not To CPR?
they wouldn't get lifepak 12's.  lifepak 500's or something would do fine.
no one at a nursing hone could do anything with a lifepak 12.

--
John
Webmaster
www.FileFlash.com
www.fileflash.com/reebok
AIM: reebokEMT


Quote:



> > My first question is this:
> > In order to spare everyone involved the necessity of following what
> > seems to be an undesirable procedure in such a case as I've described
> > above, why don't nursing homes keep onhand the electric shock
> > cardio-resusitating equipment that would avert the need for applying
> > cpr in the first place?
> One word: Money
> LifePak12 costs (i think) around $AUS12, 000 (pretty sure of this).  Image
> the cut backs in quality of patient care, staffing, facilities etc. if the
> often poorly government- supported (hah! there's an oxymoron!) aged care
> facilities had to fork out for this.  In an ideal world, yes, every
nursing
> home would have one, while we're at it we'd improve the working and living
> conditions. However this is not an ideal world and this ain't an ideal
> solution.
> 'Fraid that's what it comes down to in our society: Money



Sun, 28 Nov 2004 19:59:36 GMT
 To CPR or Not To CPR?
If they're Healthcare Provider CPR certified by the AHA (heh, and it
probably isn't a good idea to assume that they are) then they have and will
continue to have AED training.

--
John
Webmaster
www.FileFlash.com
www.fileflash.com/reebok
AIM: reebokEMT


Quote:
> This is largely an issue of money.  It would require additional money
> to purchase the required equipment.  In addition, it would require
> additional training for the medical staff who would have to maintain
> this certification.



Sun, 28 Nov 2004 20:03:28 GMT
 
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