Yesterday, while riding my bike, I came upon the scene of a man down on the path. Two bystanders had just started CPR. The man looked to be about 60 and fit. I jumped into help these heroes, who as non-medical men, had done a great job at basic life support. The pulses and respirations were good.
It seemed like an eternity as we waited for the squad to arrive. I wished that I could intubate the patient because he was vomiting and would certainly aspirate vomit into his lungs, but we pressed on. His color actually improved.
When they arrived, the squad used an automatic defibrillator that converted his rhythm to normal and they intubated the man.
I heard this morning that he was in the ICU at the local hospital. Of course, that’s all the information I could get. It’s really weird treating a patient and not having any access to follow-up information, but that’s the system.
Here’s the point: this situation is what CPR was designed for. To help relatively healthy individuals with a cardiac problem. What CPR is not good for and, in fact, does more harm than good, is in the case of elderly people with other medical problems. They do terrible with CPR, often sustaining injuries and the survival rates, even to hospital discharge are less than 5% for out of hospital cardiac arrests. Older people need to think ahead and consider the issue of Code status with their physicians.