We have seen this work in the case of Mr. Hamlin. Chest compressions started immediately, minimizing the amount of time his brain was deprived of oxygen. A defibrillator was present and used appropriately, capable of returning his heart to a normal rhythm. This process is called the “chain of survival”. If any step is missing or even delayed, someone who might have survived could die or survive leaving only severe brain damage.
Sadly, in cardiac arrests that occur outside the hospital, like this one, CPR bystander is only done about a third of the time. that is less likely are received by racial or ethnic minorities. This is important – if CPR is started right away, the chances of survival can be double or even triple — and is a strong argument for the continuing education of national and local organizations to train people, even at a young age, in simple principles of resuscitation and in favor of access better with a defibrillator. If Mr Hamlin had collapsed on the street and not on the football field, his outcome could have been different.
But in the intensive care unit, the question is not whether we have the infrastructure to do high-quality CPR, but whether we should use it. As opposed to an arrhythmia or a possible heart attack caused an arrest outside the hospital in a previously healthy person, these stories are different. Many of these patients are in the terminal stages of a deadly disease before their hearts stop beating. We see codes in ventilated patients with severe respiratory failure, advanced cancer, or sepsis whose blood pressure continues to fall despite increasing doses of medication to raise blood pressure.
In this population of intubated patients in the ICU, only 6 percent people who have had a cardiac arrest and are resuscitated will leave the hospital with little or no brain defect. For the vast majority, CPR becomes one more act that must be performed before death, one more medical ritual, than a potentially life-saving intervention with a real chance of success.
Decades ago, patients were told by doctors not to resuscitate – often without them even realizing it. This decision is documented with a note or a coded symbol on the chart, visible to the medical staff but not to the patient himself. In other cases, when they believe CPR is futile but a family insists, doctors will plan to run “slow code,” skipping the most aggressive steps.
Maybe we’ve gone too far in the other direction. We frequently take resuscitation action against our better judgment, in a way we don’t do for other procedures. And when there is no reasonable hope of any meaningful benefit but we still offer CPR as an option, we could be at a disadvantage to patients and their families. Just as increasing knowledge and training on CPR for bystanders is essential for us to give others like Mr Hamlin the best chance of survival and recovery, so receiving What CPR cannot do is also essential.
When Mr. Hamlin awoke, still intubated, Mr supposed to have Ask in writing which team won the football match on Monday. It was as if he had just woken up from a long sleep and wanted to know what he had missed. In response, his doctors told him he had won the game of life.
