CPR IS NOT LIKE ON TV
This list brought to you by a tired intern who desperately needs to have a successful resuscitation. NaLiWriMo D4
- •Many arrests are unwitnessedSo you start CPR not knowing how long the patient has been "out". Especially true in busy, understaffed hospitals.
- •There isn't always someone who takes immediate chargeThe first few seconds is an uncertain shuffle before someone decides that they are the most experienced and should take the lead.
- •You feel ribs cracking underneath your palmsIt's a sensation you won't forget.
- •The bed is unsteady and jerks with every moveEspecially in the first frantic moments when you wait for the bed board to arrive and also until someone remembers to put brakes on the stretcher.
- •Not everybody knows what they're doingSometimes you're lucky but often you find yourself with trainees and people who don't have ACLS or people who were just trained completely differently than you were.
- •There is blood and vomit and feces everywhereHopefully you remembered to don gloves before you started chest compressions. Hopefully you have an extra set of scrubs.
- •You get so exquisitely tiredThree cycles of thirty compressions sounds so easy but you're exhausted before you reach the first.
- •Needlestick injuries are a huge riskYou're trying to save a life so you delay discarding your sharps properly or you forget to watch for other people's sharps or you're unlucky and accidentally stab the person next to you. Or some of the bodily fluids splash into your eyes.
- •You don't just shock everyoneHonestly
- •CPR is rarely successful.The success rate is at its highest for respiratory failure (18.9%), drops to 7.2% for head injuries and 2.7% for renal failure.
- •And if you survive CPR, you're still not in the clearThe 24 hour survival rate is 9.2%, the rate for survival til discharge is 8.3%.
- •So what saves lives?Early fluid resuscitation, identifying the problem and solving it; or, as doctors worldwide would prefer: not being sick or injured in the first place.
- •Nobody proclaims loudly "time of death"Everybody dejectedly removes their gloves and starts cleaning up and then a nurse remembers to ask, what was the time?
- •Because often by the time someone needs CPR, the window of opportunity has passed.But still, that doesn't make us feel any less crappy when we lose someone. And still, we try our darnedest.