That is a very important and debatable topic especially in health care.When you know that sometimes a patient will be unresponsive to treatment irrespective of what you the provider will do especially during situations like performing CPR on an individual who is and will not be responsive, due to many factors like when the patient is prone or the patient already passed on.
In an article written by Dr David Schiedermayer, he elaborates on a similar case, where he examines the decision to forgo CPR in elderly patients because of other complications it may bring to the elderly patient (Schiedermayer;, 1988). Because they are already vulnerable and have weaker body structure to sometimes withstand the pressure that comes with CPR.
As I read more into your topic, i found similar discussing the situation. In Mechanical CPR: Who? When? How? the authors examine the circumstances in which CPR should be performed and what should determine CPR, how it should be done to be effective and why it is not effective on certain patients (Poole et AL, 2018)
Poole K;Couper K;Smyth MA;Yeung J;Perkins GD;, K. (2018, May). Mechanical CPR: Who? When? How? https://pubmed.ncbi.nlm.nih.gov/29843753/
Schiedermayer, David. (1988, October). The decision to forgo CPR in the elderly patient. https://pubmed.ncbi.nlm.nih.gov/3418876/
This is a topic that a lot of healthcare workers don’t feel comfortable talking about, but is very important and interesting. Before COVID-19, while working in the emergency department, I would frequently see Code-Blues. They consume the department as everyone is trying to do their part to help the patient in cardiac arrest. These are mentally and physically exhausting for everyone involved. I could not imagine working in that same environment with a much higher acuity patient population due to COVID-19. I definitely respect and appreciate all of the work that hospital and prehospital workers do.
I read an article about the safety for medical professionals in the treatment of cardiac arrest in COVID-19 patients. The WHO considers CPR to be an aerosol generating procedure, and therefore recommends that all people coming in contact with the patient must don full PPE before initiating CPR. As the donning of full PPE takes a considerable amount of time, I wonder if this is part of the reason why COVID-19 resuscitation outcomes are so poor. I wonder if other techniques to deliver chest compressions sooner could be utilized like mechanical chess compression devices like the LUCAS, while hospital staff are able to don PPE before entering the room.
Couper, K., Taylor-Phillips, S., Grove, A., Freeman, K., Osokogu, O., Court, R., Mehrabian, A., Morley, P. T., Nolan, J. P., Soar, J., & Perkins, G. D. (2020). COVID-19 in cardiac arrest and infection risk to rescuers: A systematic review. Resuscitation, 151, 59–66. https://doi.org/10.1016/j.resuscitation.2020.04.022
This brings up a very prevalent and important ethical dilemma for healthcare workers especially during the pandemic. In fact, New York attempted to implement a mandatory Do Not Resuscitate order in order to circumvent this and minimize infection of emergency caregivers, during the peak of the first wave of Coronavirus hospitalizations (Campanile, 2020). The state-wide plan prevented emergency workers from resuscitating anyone without a pulse on the scene. (Campanile, 2020). This order was almost immediately revoked (a couple of hours late) after outrage from the first responders themselves according to an article by the New York Post (Campanile, 2020).
Campanile, C. (2020, April 22). New York scraps do-not-resuscitate order during coronavirus pandemic. Retrieved from https://nypost.com/2020/04/22/new-york-scraps-do-not-resuscitate-order-during-coronavirus-pandemic/
That is a very important and debatable topic especially in health care.When you know that sometimes a patient will be unresponsive to treatment irrespective of what you the provider will do especially during situations like performing CPR on an individual who is and will not be responsive, due to many factors like when the patient is prone or the patient already passed on.
ReplyDeleteIn an article written by Dr David Schiedermayer, he elaborates on a similar case, where he examines the decision to forgo CPR in elderly patients because of other complications it may bring to the elderly patient (Schiedermayer;, 1988). Because they are already vulnerable and have weaker body structure to sometimes withstand the pressure that comes with CPR.
As I read more into your topic, i found similar discussing the situation. In Mechanical CPR: Who? When? How? the authors examine the circumstances in which CPR should be performed and what should determine CPR, how it should be done to be effective and why it is not effective on certain patients (Poole et AL, 2018)
Poole K;Couper K;Smyth MA;Yeung J;Perkins GD;, K. (2018, May). Mechanical CPR: Who? When? How? https://pubmed.ncbi.nlm.nih.gov/29843753/
Schiedermayer, David. (1988, October). The decision to forgo CPR in the elderly patient. https://pubmed.ncbi.nlm.nih.gov/3418876/
This is a topic that a lot of healthcare workers don’t feel comfortable talking about, but is very important and interesting. Before COVID-19, while working in the emergency department, I would frequently see Code-Blues. They consume the department as everyone is trying to do their part to help the patient in cardiac arrest. These are mentally and physically exhausting for everyone involved. I could not imagine working in that same environment with a much higher acuity patient population due to COVID-19. I definitely respect and appreciate all of the work that hospital and prehospital workers do.
ReplyDeleteI read an article about the safety for medical professionals in the treatment of cardiac arrest in COVID-19 patients. The WHO considers CPR to be an aerosol generating procedure, and therefore recommends that all people coming in contact with the patient must don full PPE before initiating CPR. As the donning of full PPE takes a considerable amount of time, I wonder if this is part of the reason why COVID-19 resuscitation outcomes are so poor. I wonder if other techniques to deliver chest compressions sooner could be utilized like mechanical chess compression devices like the LUCAS, while hospital staff are able to don PPE before entering the room.
Couper, K., Taylor-Phillips, S., Grove, A., Freeman, K., Osokogu, O., Court, R., Mehrabian, A., Morley, P. T., Nolan, J. P., Soar, J., & Perkins, G. D. (2020). COVID-19 in cardiac arrest and infection risk to rescuers: A systematic review. Resuscitation, 151, 59–66. https://doi.org/10.1016/j.resuscitation.2020.04.022
Ben,
ReplyDeleteThis brings up a very prevalent and important ethical dilemma for healthcare workers especially during the pandemic. In fact, New York attempted to implement a mandatory Do Not Resuscitate order in order to circumvent this and minimize infection of emergency caregivers, during the peak of the first wave of Coronavirus hospitalizations (Campanile, 2020). The state-wide plan prevented emergency workers from resuscitating anyone without a pulse on the scene. (Campanile, 2020). This order was almost immediately revoked (a couple of hours late) after outrage from the first responders themselves according to an article by the New York Post (Campanile, 2020).
Campanile, C. (2020, April 22). New York scraps do-not-resuscitate order during coronavirus pandemic. Retrieved from https://nypost.com/2020/04/22/new-york-scraps-do-not-resuscitate-order-during-coronavirus-pandemic/