EMSconnect On Shift

On Shift Review: "The Hidden Harms of CPR"

September 25, 2023 EMSconnect, LLC Season 2 Episode 19
EMSconnect On Shift
On Shift Review: "The Hidden Harms of CPR"
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Show Notes

Well, this one sure caught our attention. Shaun Pitts and Dr. Travis Dierks dive into the recent article published in The New Yorker: "The Hidden Harms of CPR" by Sunita Puri.
This raises the ethical question, should EMS be doing CPR on patients that are VERY unlikely to survive? We know that all patients have the right to refuse care, and on the flip side, have the right to demand care, and EMS is caught right in the middle of a legal and more often ethical grey area. 

Link to  article: https://www.newyorker.com/news/the-weekend-essay/the-hidden-harms-of-cpr?fbclid=IwAR2EoZ1S4DNbDk5xXILzC4PThVo_LyUH51mEVUEC-CRXf0sWXRySkpCcaAI

Link to Dr Dierks reference: https://www.bmj.com/company/newsroom/patients-overestimate-the-success-of-cpr/#:~:text=Patients%20and%20the%20general%20public,online%20in%20Emergency%20Medicine%20Journal.

Links to studies found on damage from CPR: 

  1. Ouellette l, Puro A, Weatherhead j, Chassee T, Whalen D, Jones J. Public knowledge and perceptions about cardiopulmonary resuscitation (CPR): Results of a multicenter survey. American Journal of Emergency Medicine 2018;36(10): P1900-1901. Available at: https://www.ajemjournal.com/article/S0735-6757(18)30117-7/fulltext.
  2. Peberdy MA, Kaye W, Ornato JP, Larkin GL, Nadkarni V, Mancini ME, et al. Cardiopulmonary resuscitation of adults in the hospital: a report of 14720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation. Resuscitation 2003;58;297-308. Available at: https://www.ncbi.nlm.nih.gov/pubmed/12969608
  3. Girotra S, Nallamothu BK, Spertus JA, Li Y, Krumholz. Trends in survival after in-hospital cardiac arrest. New England Journal of Medicine 2012 Nov 15;367(20):1912-20. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3517894/
  4. van Gijn MS, Frijns D, van de Glind EMM, van Munster BC, Hamaker ME. The chance of survival and the functional outcome after in-hospital cardiopulmonary resuscitation in older people: a systematic review. Age and Ageing 2014;43(4): 456-463. Available at: https://academic.oup.com/ageing/article/43/4/456/2812217
  5. Sehatzadeh S. Cardiopulmonary Resuscitation in Patients With Terminal Illness: An Evidence-Based Analysis.Ontario Health Technology Assessment Series 2014; 14(15): 1–38. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552960/
  6. Scholz KH, Tebbe U, Herrmann C, Wojcik J, Lingen R, Chemnitius JM, et al. Frequency of complications of cardiopulmonary resuscitation after thrombolysis during acute myocardial infarction [see comments]. Am J Cardiol.1992; 69:724–728.Available at: https://www.ajconline.org/article/0002-9149(92)90494-J/pdf
  7. Kralja E, Podbregarb M, Kejžarc N, Balažica J. Frequency and number of resuscitation related rib and sternum fractures are higher than generally considered. Resuscitation. Aug 2015. 93:136-141. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404201/.

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