The myth of CPR

I have been reading Stefan Timmermans book Sudden Death and the Myth of CPR  which is an intense but fascinating history and analysis of CPR.  

Here is an article on the same subject by Ken Hillman which succinctly covers much of the same ground.

Timmerman, Hillman, and David Newman, author of Hippocrates’ Shadow take the position that the success rate of CPR is extremely low.  There are very few survivors and of those who survive, a high percentage end up in a coma or with severe brain damage.

Here is a brief but important excerpt from Hillman’s article. I encourage you to read the entire piece.

 

Even if performed optimally, CPR after the heart has stopped is often not successful in restoring life. After their first few cardiac arrest calls, medical trainees intuitively begin to understand that CPR is usually a “last rites” ritual – a continuation of the focus of modern medicine on doing everything possible to restore and sustain life. Only about 15 per cent of patients requiring CPR in a hospital and approximately 1 per cent of patients who have arrested in the community and had CPR survive to leave hospital. And this dismal figure hasn’t changed since CPR was first introduced in about 1960. Moreover, these figures do not give any indication of what state the survivors are in. Many are in a coma or have severe brain damage. This is not the impression we get from medical programs on television, where success rates appear to be around 70 per cent.

How did such a poorly proven intervention become a routine end to many people’s lives? While there are many articles about the anecdotal success of CPR, there are few extensive studies putting the success stories in the context of, for example, which groups of patients CPR is more effective in reviving. It is estimated that providing a hospital CPR service costs approximately $450,000 per survivor, making it one of the most expensive procedures in medicine.

On the other hand, large research departments all around the world spend millions on determining the most effective number of chest compressions and artificial breaths that should be applied per minute; and whether drugs be given intravenously or directly into the heart; and what drugs and at what doses these drugs should be given. Thousands of dogs and other animals are sacrificed in these experiments.

Even for the approximate 15 per cent of patients who survive to leave hospital, we know little about the eventual state of those survivors, nor about the ones who didn’t leave hospital. Were they left on ventilators or discharged in a vegetative state to some kind of institution? The CPR industry has moved a long way and is redefining what exactly is meant by resuscitation within an acute hospital setting, extending its boundaries for research and recommendations to meet the needs of the seriously ill before they actually have a cardiac arrest or die.

much much more via The myth of CPR | Inside Story.

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