Cardiopulmonary Resuscitation (CPR)


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When is CPR important?

CPR may be done when a person stops breathing or the heart stops beating (like when a person has a heart attack or almost drowns). When it's possible that the person may get better, CPR is an important life-saving technique. CPR can help keep oxygenated blood circulating in the body, which can help prevent brain and organ damage.

However, when a patient has an advanced life-threatening illness (such as advanced stages of cancer) and is dying, CPR may not be the best option. It's important for the patient, family members and doctor to talk about this issue before the need arises.

What happens during CPR?

CPR consists of 2 stages: chest compressions (forceful pressing on the chest to stimulate the heart) and artificial respiration (mouth-to-mouth rescue breathing).

Electric stimulation to the chest (called an automated external defibrillator or AED, which a device that help start the heart) and special medicines are sometimes used to resuscitate a person whose heart has stopped beating. This is usually done for 15 to 30 minutes. A tube may also be put through the mouth or nose into the lung. This tube is then connected to a breathing machine and helps the person breathe.

What happens if CPR isn't done?

A person will become unconscious almost immediately and will die in 5 to 10 minutes.

What are the benefits of CPR?

For a patient who has an advanced life-threatening illness and who is dying, there are really no benefits.

CPR may prolong life for patients who have a better health status or who are younger. CPR may also prolong life if it's done within 5 to 10 minutes of when the person's heart stopped beating or breathing stopped.

What are the risks of CPR?

Pressing on the chest can cause a sore chest, broken ribs or a collapsed lung. Patients with breathing tubes usually need medicine to keep them comfortable. Some patients who survive may need to be on a breathing machine in the intensive care unit (ICU) to help them breathe for a while after they receive CPR.

Few patients (fewer than 10%) in the hospital who have had CPR survive and are able to function the way they used to. Many patients live for a short time after CPR, but still die in the hospital. CPR may also prolong the dying process.

Patients who have more than one illness usually don't survive after CPR. Almost no one who has advanced cancer survives CPR and lives long enough to leave the hospital. Of the few patients who do, many get weaker or suffer brain damage. Some patients may need to live on a breathing machine for the rest of their lives.

How do I learn CPR?

CPR is a skill that you need to learn by taking an accredited first-aid training course. This course will probably teach you how to perform CPR and how to use an automatic external defibrillator (AED).

Source

Withholding and Withdrawing Life-Sustaining Treatment by RJ Ackermann, M.D. (American Family Physician October 01, 2000, http://www.aafp.org/afp/20001001/1555.html)

Some information in this handout comes from Education for Physicians on End-of-Life Care Trainer's Guide, Module 11, withholding, withdrawing therapy. In: Emanuel LL, von Gunten CJ, Ferris FD. Education for physicians on end-of-life care/Institute for Ethics at the American Medical Association. Chicago, IL: EPEC Project, The Robert Wood Johnson Foundation, 1999.

Written by familydoctor.org editorial staff

Reviewed/Updated: 12/10
Created: 09/00

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