CPR not always effective for elderly
March 12, 2013
When the media reports on sensational, titillating 911 calls, damaging misinformation often flourishes.
CPR stands for Cardio Pulmonary Resuscitation. This is a method of trying to restore circulation and breathing for a person who has no pulse or is not breathing.
The downward force exerted on the chest by CPR can result in fractured ribs, especially in the elderly, whose bones are more fragile. Broken ribs are not only painful; they can also puncture a lung and lead to mechanical ventilation and the need for a chest tube to reinflate the lung. Fractured ribs can also lacerate the liver or spleen.
On television, 75 percent of the time the victim receiving CPR is successfully revived. The fact is CPR is almost never successful. Actually, when a victim's heart is restarted, it is usually the result of using a defibrillator, which electrically shocks the heart into starting again.
In reality, many of those who are revived by CPR wind up severely debilitated.
The cold, hard truth is that CPR is less than 3 percent effective for elderly victims with medical problems (see "CPR Is Less Effective Than We Think," Dr. George Lumberg).
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Television depicts the end result of CPR as death or a full recovery. In reality, many of those who are revived by CPR wind up severely debilitated. A study completed in 2010 (NPR Podcast, "The Bitter End") found only 8 percent of those revived by CPR survive a month. Of those 8 percent, 3 percent have a good outcome, 3 percent end in a chronic vegetative state, and 3 percent are not comatose but not functioning.
This is not to say CPR should be abandoned in dire situations. A drowning victim should promptly receive CPR. When a person has stopped breathing because of low body temperature or another readily reversible condition, the success rate is pretty good.
On the other hand, when an elderly person has stopped breathing because of heart problems or pneumonia, especially when other medical problems are present, CPR has a very low success rate and creates complications and tribulations the recipient of the CPR didn't want and didn't ask for.
The family of the woman denied the CPR fully supported the decision of the facility.
"It was our beloved mother and grandmother's wish to die naturally and without any kind of life-prolonging intervention," said the family "We regret that this private and most personal time has been escalated by the media," the statement said.
The low success rate of CPR may be an example of how a medical myth is perpetuated by the media because it is more appealing than the truth. Unfortunately, sugarcoating the concept of CPR leads to unrealistic expectations.
For information, research, "How Doctors Die — What Doctors Want From End of Life Care."
Carol Young is a resident of South County.