Are you dead before CPR?

When a person needs CPR, it is because his or her pulse and breathing has stopped—clinically, they are already dead.

cprcertified.com - What Happens if You Fail at CPR-and Someone Dies

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If you’re a healthcare provider, this may be a sadly common occurrence in your life. But if you aren’t—if you’re just a bystander, and you suddenly find yourself called upon to provide CPR—it can be devastating when you give everything to try to save someone, and they don’t make it. It isn’t unusual, though—and you shouldn’t let the fear of a bad outcome keep you from learning the skills you need to provide CPR. Here are some examples of the questions and concerns we’ve heard from people in our CPR classes about what happens when the outcome isn’t the best.

If I give CPR and the patient dies, how will I live with myself?

The first thing you need to realize, if this happens to you, is that it is not your fault. That’s worth repeating: if someone dies even though you did the best you could to give them CPR, it isn’t your fault. What most people don’t realize is that, even though it can save lives, CPR alone isn’t designed to. When a person needs CPR, it is because his or her pulse and breathing has stopped—clinically, they are already dead. What CPR is designed to do is move oxygenated blood through a clinically-dead body to buy the victim just a few more minutes of time for medical personnel to arrive and prevent biological death—which happens when the brain doesn’t get oxygen for more than a few minutes. CPR doesn’t usually save lives on its own. The technique only delivers about 25% of the oxygen to the brain that it needs to survive; it is not meant to keep a person alive long-term or restore them to health on its own. Also, despite what we see in movies and TV shows, CPR works in only a small amount of cases even when conditions are exactly right. Only about 2% to 18% of people who receive CPR survive—the number depends on the study you read, whether the victim received bystander CPR before paramedics arrive, and a variety of other factors. But even at the high end, death is by far the more common outcome, despite the rescuer’s best efforts. Generally, CPR is meant to give a person a better chance at survival while they wait for medical help to arrive—but that chance is still slim, and many don’t make it. That isn’t your fault.

What if I give CPR, the patient dies—and the family sues? Will I be in trouble?

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There’s another worry many people have if someone dies after they give CPR—the worry that they’ll be sued. In today’s litigious climate, it isn’t an unreasonable concern. And when some facilities go so far as to forbid their employees to deliver CPR under certain circumstances, even to people who could die without it—and have—it’s easy to assume that a lawsuit is a distinct possibility if you give CPR and something goes wrong. The truth is that, as a bystander, you are very unlikely to be sued for giving CPR, regardless of the outcome—and if you are, it’s farfetched that the judgment will be against you. Here’s why. Most states have a Good Samaritan law in place that is designed for exactly this situation—to protect people who give CPR in good faith. Generally, you must be acting out of selflessness, not for a desire for monetary reward—and accepting payment for delivering CPR, even after the fact, can weaken those legal protections. The law varies by state, and so does whether or not you need to be CPR certified for them to apply. In some states, the law is only meant to apply to people with medical training—although under the law, that may also apply to people with CPR certifications. In other states, everyone is covered regardless of their certification status. Most Good Samaritan laws don’t cover people who give care that they are extremely undertrained to deliver. For instance, if you are not a surgeon and attempt impromptu surgery on the sidewalk to save a patient, you may be liable in court for the outcome. However, in cases that aren’t that extreme, this doesn’t apply if you aren’t CPR certified or your certification has lapsed, and you deliver CPR anyway. In some states, you may be legally required to provide CPR—even if the victim dies, you may have had no other option. This applies mainly to people in the medical profession, such as doctors, nurses, EMTs, and first responders. People in this category often have a “duty to act,” which means they must provide CPR under the law, even to the point of stopping if they see an accident on a highway. In Vermont, that law extends to most bystanders. Everyone, even non-medical personnel, is required to provide “reasonable assistance” to a victim as long as providing it doesn’t put the rescuer in danger. Even if the person you provided CPR to died, you may have been legally required to provide that care—and it’s unlikely you’ll be found culpable for anything in court. Some people worry about the requirement for consent to provide CPR. Technically, it’s true that the patient must usually give consent to receive CPR. However, if the patient is so impaired that they cannot provide consent—as in cases of cardiac arrest—the law generally expects rescuers to assume consent. When CPR is needed, every minute and second counts, so it doesn’t make sense to try to obtain consent first from an unconscious patient.

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Our caveat, of course, is that we are not lawyers and none of the above should be construed as legal advice. If you have concerns about your specific situation, it’s best to talk to a lawyer.

What if I gave CPR, the person died, and I find out later about their DNR?

A DNR—or “Do Not Resuscitate”—order is supposed to protect patients from receiving CPR and other lifesaving care if they do not want it, even if they are incapacitated and can’t tell rescuers not to give them the care. Sometimes you hear about instances in the news where a nurse or other CPR-certified staff member is prevented from providing CPR to a patient who needs it. Usually, that’s because the patient has a DNR, and the employer is worried about a lawsuit. However, bystanders who don’t know the victim are usually protected by Good Samaritan laws as they cannot be expected to know about a patient’s DNR, as long as they are acting in the patient’s best interests in compliance with their training. In all, it is 100% worth it to learn CPR skills and deliver CPR to someone who needs it—even if the outcome isn’t a positive one. In addition, you are extremely unlikely to get into any trouble if the person you are delivering CPR to does not survive—state laws are designed to protect well-meaning bystanders. Even if the patient does not survive, you will still have given that person a chance to survive, and in some cases it will work. You can never know ahead of time which it will be, and anything is worth giving a dying person an increased chance of survival.

cprcertified.com - What Happens if You Fail at CPR-and Someone Dies

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