Pain, Drawbacks of CPR Prompt a Reassessment

Procedure is much more successful on TV shows than in real life
By Bob Cronin,  Newser Staff
Posted May 30, 2023 4:44 PM CDT
Undergoing, Administering CPR Can Inflict Trauma
A woman demonstrates CPR on a mannequin in a first-aid class.   (Getty/MyndziakVideo)

CPR seems like a lifesaver, and it can be. But there are drawbacks that receive less attention, NPR reports. The trauma is serious enough to prompt nurses to refuse to perform CPR on some patients and as many as half of patients who survived after undergoing the procedure to still wish they hadn't had it. And CPR isn't as successful in real life as it is on TV, anyway. Research in 2015 showed that the survival rate after fictional cardiac arrest was about 70%. People not on TV similarly estimate the survival rate in the real world to be at least that high. But it's not even close. A 2010 review of studies put the survival rate after CPR was performed outside of a hospital setting to be 7.6%.

The misperceptions could be part of the reason for the campaigns to learn how to administer CPR. Occupations that require CPR certification include flight attendants, coaches, and, sometimes, babysitters. Public classes began in the 1970s. Johns Hopkins researchers who first used the procedure on people in 1959 wrote that anyone could try to resuscitate a cardiac patient. "All that is needed is two hands," they said, adding that the most common complication is fractured or cracked ribs. Pulmonary hemorrhage, liver lacerations, and broken sternums also can result.

A nurse who refused to perform CPR on an elderly woman who had asked to be allowed to die naturally faced criticism, per NPR. Such instructions are part of the issue. Patients and their families often are asked if they "want everything done" if the patient's heart stops; families can be reluctant to sound like they don't. That question could be rephrased to ask if the patient prefers a natural death, recognizing that CPR can inflict pain for only a short-term gain. One physician, who did chest compressions on an elderly patient while feeling his ribs crack like twigs, said she had nightmares about it. "I felt like he deserved a more dignified death," said Holland Kaplan. That's not an isolated case, said Kaplan, adding that with CPR, "the bad experiences far outnumber the good ones, unfortunately." (More CPR stories.)

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