CPR for older people?

[DaleC]

I deal with elderly (80's -90's) people recovering from major fractures all the time. Your source is a dough head.

 

[DivemasterDennis]

Cutting through the several "legal" mis-statements, and focusing on the medical issue, I as an older diver ( though only 60, not 80 or 90 yet- hope to be someday) am glad to hear from the medically trainer contributors to this thread that if I am laid out with my heart not beating, they will not hesitate to attempt to give me the gift of life through reasonable cpr efforts. Thank you. I have now put TC on my list of people to buddy with if we are ever in the same ocean.
DivemasterDennis

 

[Tigerman]

There are circumstances where CPR is inappropriate. It is inappropriate if the person has executed a document requesting that it should not be done. It is inappropriate if the person has a serious medical illness and is already receiving all conceivable therapy to reverse or support their illness, but has arrested anyway (this is an ICU scenario). In my personal opinion, which has no basis in law, it is inappropriate if the person is suffering from dementia severe enough that they are no longer able to perform the activities of daily living without major support.

None of these scenarios has any relevance to diving. No matter how old the diver, they deserve an attempt at resuscitation. Ribs heal, and it is entirely incorrect that a person who had received CPR would live the rest of their life in terrible pain.

In diving I would assume the person would be of such an age and overall health (other than the event) that they would be able to make a good recovery.

Outside of diving, I am NOT a medical professional and as such I will NOT make the decision to let anyone die if Im in a position to help, simply because that is NOT MY CALL TO MAKE.

 

[The_Aviator_1]

Just from a recent experience. My rescue arrived to find a 60ish year old man in cardiac arrest. We performed CPR and broke a bunch of ribs. In addition to all our advanced life support we brought him back. Three weeks later he came to our station to thank us and pulled up his shirt and yelled "who did this?!" Exposing all his brusing and some mishapes on his check. He was laughing about it and said it was uncomfortable to cough and sneeze but otherwise it just ached. He seemed pretty happy to be alive. That emt was a tard who doesn't belong in medicine. (Firefighter/paramedic/acls/bls/pepp/amls/NPR/itls instructor)

 

[TSandM]

Is it possible that you might resuscitate someone who wouldn't live very long, and would have pain from rib fractures? Sure. If it were you, would you want to buy a few days or a week of life, to be able to put things in order and say goodbye to folks? I think I would.

The only time I think resuscitation is really wrong is when we bring back someone who is neurologically devastated and never gets back to any level of function. Rib fractures don't even form a blip on the horizon, when I think about whether it's right to resuscitate someone or not.

 

[Tigerman]

I have experienced rib fractures and I have to say that yeah, itll hurt a couple of weeks and youll feel a little crippled due to the pain when you do things, but really it didnt make me wish I was dead..
I didnt break them due to CPR though, I was just being dumb while skiing

 

[The_Aviator_1]

It is conceivably possible they could be resuscitated and die shortly after (cardiac arrest is a highly traumatic event). However with modern practices it's almost impossible to tell what the neurological outcome will be for quite a few hours. Often after an arrest, patients are kept under and hypothermia is induced to protect the body and organs for at least 18 hours. If someone were to come back and have significant pain, it would be managed accordingly by the medical provider with analgesics. The longest arrest ive had that has come back with limited neuro deficit was 45 minutes of CPR. The point being everyone deserves a chance in the absence of a do not resuscitate order. Without a cardiac monitor you won't know what your odds are of saving them so just push hard and push fast until you can get to EMS

 

[Bratface]

Personally, I'll take my chance at living with the broken ribs.

 

[TMHeimer]

As a layman, I agree with all that say give CPR regardless of age. The only time I've heard it is wise not to be too rough is with very young children--and small slow puffs with rescue breaths-- (and you can see that with babies on Grey's Anatomy too). However, every time I've taken an EFR review class something has changed, so who knows what's next?

 

[pjhansman]

My vote as an "old guy"......I'll take my chances with the broken ribs. If I'm feeling the pain, at least I'm still alive.