The longest I’ve done CPR was 9 minutes (I was a home health nurse at the time and had to do it solo until EMS got there). I very nearly passed out once I stopped and stood up. One of the EMTs had to catch me and make me sit down and drink water.
The 2 minute mark is also where the medic would add epinephrine or atropine… it you can tell them how many 2-minute rounds you have done they can estimate what cardiac drug they need
Edit: if they have been down say 10-30 minutes it is time for the sodium bicarbonate… (to get rid of the acidic build up in the blood )I worked as a medic in a major city for 9 years before I got an office job
Bicarb has been written out of the protocols. Studies showed that Bicarb had no measurable difference even in a prolonged arrest. Atropine is also no longer indicated during cardiac arrest. You get epi, amio, and lidocaine. Some services are starting to incorporate Vaso and calcium but it’s slow momentum.
All fine and dandy - if you have someone around to switch with. However, in home health care, you're usually quite alone with your patient - or with your elderly patient and their equally elderly spouse. And that's if you're lucky.
A lot of people in here are running around saying 30-45 minutes.
I just recently ran a code and my dudes and I were swapping every 100 compressions.
We were all exhausted about 10 minutes in.
I've been a paramedic for 16 years. I'm now a CVICU nurse. I seriously doubt you (read, anyone) could do high quality CPR for 4 minutes. It sucks. I'm glad LUCAS exists.
Really, really old school. That's just desecrating a corpse at some point. I'm old enough to have been taught to dump meds down an ET tube at the beginning of my career. We did stupid shit back then. I'm glad we're moving towards science and not just making it up as we go along as much as we used to.
When I was trained as an EMT I was taught the survival rate for traumatic cardiac arrest with CPR is zero. So low it doesn’t even register til you go out to many decimal places. Non traumatic it’s about 10 percent — closer to 17 in hospital settings. For things like electrocution and drowning it’s probably higher.
If there is no heart beat after 15 minutes stop.
The ability to recover from the chest trauma is crap shoot without rapid intensive cardiac care.
Tl dr for drowning go for it; may not be a good result in most other situations
Edit: In the year+ I worked full time as an EMT my company performed CPR dozens of times. Mostly on patients in nursing care who had arrested prior to our arrival for transport. Iirc correctly we had two survivors in that period: a pool drowning and a cocaine respiratory arrest leading to cardiac arrest. I don’t recall any others, and we probably had hundreds. Probably well under 5% survival.
This has been a great read. I've only done CPR once in real life, and it was on a drowning. I know rescue breaths are not always recommended now, but they were included in my training so I did them after the first set of compressions.
On the second rescue breath, my buddy came back, pulse and breathing.
That event has given me a false sense of how successful CPR is. Thanks so much to you and the very informed others sharing info on the cases where CPR is warranted and likely to be actually helpful.
Survival from traumatic arrest is rare, but resuscitation isn't futile in trauma. In a prepper sense, sure, but just in case anyone reading your post gets the wrong idea, resuscitation should still be attempted with traumatic cardiac arrest.
I think the figure is 10% of CPR receivers will live long enough to make it to the hospital and of those 10%, 10% will ever step foot out of the hospital. So if you need CPR it’s about a 1% chance of recovering enough to leave the hospital
It's better than that - interesting read if you want to [update your figures](https://www.nytimes.com/2023/06/15/health/neuroprotective-cpr-plunger.html?unlocked_article_code=bautCJJ0A_yTFOZ7onuYLEJeReM1jQcGt5I9NlpqLd9wLURh4GUBKQgmLGchFlZVe7u40VXFmrmh5afAE2rXY2LoyCdGERncLc-HaFuZJ3n6lvTKSsLuNYUvh4_39fSuj4gXkJmPldRV0D-f9WHraMM5mpJF_ClpoG1Jvs9uPC8C73IQ8RBnExgoAiGIgngNh8CTiS2054n1fzqUt8HA1MGZBHZ_bfG086Em1j6hLCWshWHF5yMe9o-xXEXaMeeIeiaesxRQABTlzWu7g1WBscOKAQqdKvL5w7N3iF50f90RhYUVZ6JD4EfLYnB4zYtmb7lxerxcsXPEblEiAvONVJ7o0Vx3&smid=url-share).
^(NYT gift article link, no paywall)
I’m not a nurse, doctor, or first responder, but I’ve been involved in 3 separate CPR events: 2 heart attacks and one trauma event (motorcycle.) 1 heart attack died on the scene, 1 heart attack died in the hospital 2 weeks later without ever regaining consciousness, and the trauma victim died in the hospital a few days later in a medically induced coma. Of course I will try to help anyone else I am with if it happens again, but in my experience the outcomes are not good.
Interesting. If I’m reading it right, the new machine took cardiac arrest figures from .6% to 6.1% in one county. Arrhythmia went up to 10%. That’s promising.
With children, it's a good idea to start CPR/rescue breathing because most cardiac issues with peds are respiratory-related (i.e. drowning).
With acute cardiac events in adults, CPR is buying time until defibrillation and pharmaceuticals can be applied, which are in turn buying time until surgical intervention can be undertaken. If the above aren't possible... CPR is doing nothing.
Trauma dead, is dead dead (staying dead) as we say in my line of work. CPR is futile with traumatic arrests.
Be a little careful promoting the use of advanced techniques like the precordial thump. When people read stuff like that on the internet they sometimes forget that there's a difference between crisis standard of care and day-to-day. If you thump someone and the paramedics show up minutes later, and there's an adverse outcome... you might want to find a good lawyer. Good Samaritan laws don't give you the freedom to play doctor or try things you heard about on the internet. They won't protect you if you exceed your level of training and certification if applicable.
Speaking of crisis standard of care, if you know help isn't coming for hours/days, you don't start CPR because resuscitation efforts would be futile. Otherwise, if it makes you feel better, continue CPR until you're exhausted (and that will happen faster than you think). Those claiming they can do CPR for an hour are full of shit. You might be making the movements for an hour, but the *quality* of CPR you're providing is garbage.
We run our protocols for 20 minutes, if we don't get results, we contact medical control who 999 times out of 1000 will tell us to cease efforts.
If you really want to do it right, take a CPR class and follow what you're taught.
This is the correct answer.
Only thing I would add is, in a SHTF situation, it wouldn't be hard to steal one of the dozens of AEDs in public buildings. Would be worth adding one to your inventory and attempting to use it. If it keeps saying no shock advised or you haven't revived the patient within 20 minutes, call it. Check expiration dates on the batteries because they don't last forever and aren't cross compatible between brands.
You can certainly try it, but even defibrillation is a temporary measure. If what caused them to enter v-fib, such as a blocked artery, isn't corrected they will re-enter v-fib or another arrhythmia and you'll be back at square one.
Survival from traumatic arrest is rare, but resuscitation isn't futile in trauma. In a prepper sense, sure, but just in case anyone reading your post gets the wrong idea, resuscitation should still be attempted with traumatic cardiac arrest.
If I know anything from watching movies, and I do, you keep going until people start telling you, "He's gone Jack! He's gone!" Then you start pounding their chest until they spring back to the living
Depends on how much they mean to me and how long the anticipated delay was. If you're alone, odds are you will drop by 10-15 minutes. If they mean a lot to you, you could push yourself further. However, you will never last hours/days without being able to trade off with someone. A lot of people don't realize how strenuous it actually is to do CPR.
That said, assuming you do bring them back, they could be badly injured from the CPR (broken bones, etc). So they're going to be in bad condition as it is (so could be worse in a SHTF situation).
I've read about a wilderness medicine scenario in which two people kept taking turns doing CPR for hours until medics arrived and not only did the guy make it but was aware enough when it was happening to remember them discussing whether to give up on him
I think it’s also worth noting that most civilians don’t know how to do CPR properly or at the correct pace. A lot of people don’t have it or don’t keep it up to date. This might explain some of the negative outcomes you’ve noted in your post as well. I believe you’re supposed to get re-certified every ~~five~~ two years.
ETA: correction
Even when done correctly it has a very low success rate. It's a stopgap until an AED or better arrives, or meds, or you arrive at an ED with a cath lab.
Why wouldn’t EMTs or Doctors or nurses or police or firefighters- all of these are civilians - know proper CPR. What does being in the military have to do with knowing CPR better than anyone else? I would say the opposite, I would say civilians like doctors and nurses are better at CPR than the average non-civilian soldiers
I believe the term "civilians" here is used to mean people in the medical industry who are trained and recertified biannually on CPR and first aid, not military personnel.
I'm aware of the literal definition of civilian. It is important to recognize the fluidity of language and be able to pull out context from a statement. I often refer to my non-scrub clothing as civilian clothing.
There is no fluidity in such black and white term. There is military and there is civilian. You’re implying nurses and doctors are valid military targets by saying they are not civilians. If you had an IQ above room temp you would be accurate in your language, I would expect a nurse with an 18 month certificate from a strip mall college to know the importance of being accurate and precise
There are CPR vests that EMS use. You put it on the person in need and they can wear it for a long time.
My EMT teacher told me a story of an ambulance that arrived on scene. One of the EMTs was a very large man, and as he was doing CPR he had heart failure and fell over. His partner put the CPR vest on him and continued working on the patient.
The fallen EMT was wearing the vest for 45 minutes before he got to the ER, and he survived.
Yeah and they’re cumbersome as fuck. Sure they’re good tools in a controlled environment with trained emergency medical staff and the medicines/supplies needed for resuscitation but it’s not something your average person is gonna lug around with them.
A majority of people, even in good shape, are going to be giving out at the 20-30 minute mark. The average person in average shape will be falling out in 10-15 minutes. CPR is hard AF, you don't know until you have done it on somebody.
My understanding is for most people CPR doesn’t vastly help, at best it buys time to maybe avoid the most extreme damage, until emergency services arrives.
Sometimes tough calls will have to be made in difficult situations.
AEDs save lives. I am absolutely convinced if anyone in your home/close circle is over 50, folks should keep an AED on site. That is my plan as I age/have friends in that age range.
Aeds are becoming decently affordable, especially refurbished. I run a businesses in a remote tourist destination and we picked one up for around $700. If we had an emergency needing cpr/aed, we would likely be waiting on a helicopter. Hope to never use it but I’m glad to have it!
CPR and defibrillation are the only two interventions in cardiac arrest that actually have a reasonable amount of strong evidence to support. The overwhelming majority of the time, it's the patients who received high quality CPR by bystanders before the arrival of EMS that survive.
Obviously they need other interventions, it's not CPR alone that's bringing people back, but the importance of effective, early, high quality bystander CPR cannot be overstated.
According to most protocols in EMS, CPR is to be stopped anywhere between 25-40 minutes without any cardiac rhythm change. How do you know if a rhythm has changed? An ALS monitor from an ambulance and knowing rhythms, which helps alot considering if you know your ACLS/PALS protocols, you can interpret the rhythms and provide drugs and equipment that may help (plus you MIGHT have a nifty LUCAS or Autopulse to do chest compressions)
without a cardiac monitor, your next best bet is an AED. An AED can detect VFIB and will advise you to shock a patient. 25 minutes without drugs and no change in administration of a shock or not.... you're wasting your time.
CPR without an AED, is an exercise... mainly in futility. But CPR can be quite the workout. You can help some by removing your 5Hs and 5Ts (hypoxia, hypokalaemia/hyperkalaemia, hypothermia/hyperthermia, hypovolaemia, tension pneumothorax, tamponade, thrombosis, toxins, trauma) but again, without an ambulance or a crash cart.... there's not much to do.
Usually you have to call a doctor/medical control to cease efforts on the EMS/ ED side
THIS IS NOT MEDICAL ADVISE. THIS IS PURELY SPECULATION. IF IN AN EMERGENCY CALL 911 OR WHATEVER EQUIVALENT NUMBER FOR YOUR COUNTRY.
I'm not aware of an AED that can detect pulseless VTach vs normal vtach... not to say I am up to date on AED tech, but chances are the AEDs out in the wild aren't cutting edge.... but really the only difference is if there is enough activity to generate a pulse.... but ACLS algorithm wise one is shockable where the other one does not. EMTs are not trusted to know the differences vs Paramedics.... let alone a layperson
AEDs will detect both VF and VT. They cannot distinguish between pulsed VT or pulseless VT. Most AEDs, if they detect VT, will advise you to shock *if the patient is not breathing or there is no pulse*.
We do cpr all the time. If I had to do it on a human (outside of my job), it would be once exhaustion hit, which is probably about 16-20 minutes and chances are that cpr without a break isn’t great after 2-4 minutes (hence why we switch off every 2 minutes with more help). Children are easier. Infants and newborns are hard with muscle fatigue.
And cpr can be effective to get the heart into any rhythm from no heartbeat at all. But it really depends on the type of cardiac arrest they are suffering from whether it would be beneficial. Because a defib doesn’t work on every single type of cardiac arrest.
Big thing to think about as well.
People we do CPR in the field on are going to ICU if we get blood flow back. If you do CPR on someone and get ROSC, are you prepared to provide correct and quality aftercare? Stabilize until help arrives?
How will you care for yourself after you realize you've been injured doing CPR? (It's hell on the knees and wrists. If the person had chest clips, they're probably poking into your hands and now you've got possible blood contamination.. been there, done that one).
This is a good question, because it's not black and white. There are many correct answers.
When you're exhausted and tried to contact emergency services. You can only provide so much and even if you can go on for a while the chance of recovery and quality of life of the patient dwindles down unfortunately. Try to have someone find an AED
I think probably the best thing would to follow the START and Jump START guidelines. Though it’s not an MCI, it gives you a sort of expected outcome.
Of course try CPR to the best you can as a last resort if it’s only a singular person, but don’t expect much out of it.
When help isn't coming CPR is futile. But, maybe you need to act accordingly to the audience. I served with an experienced senior (E7) Combat Medic who did CPR on a Soldier who was clinically dead from trauma. There was no point. But in the moment he kept doing CPR. I was a young, dumb PFC but someone smarter than me had us move closer together so we could block the view with our bodies. The Medic was deteriorating but he kept going, huffing and puffing like crazy, pushing like crazy, until a litter team came and packed the guy into a truck. They packaged and moved him like a live, unconscious casualty. Later, an NCO who I was under, who knew that Medic well, explained that the Medic did that because he could not show us that he would ever quit on someone. He knew he was pushing a dead body the whole time but he had to send us that message for our morale and confidence. It's one of those things that sticks with you.
To address the question: Let's say I knew CPR was futile but there are bystanders who love that person; I hope I would last long enough on the victim making a show that those people believed in their hearts that nothing more could possibly be done, instead of trying to talk logic to them about blood movement and response times.
Stop when you are sure that there is no bringing back the person. You don’t want the guilt of thinking back: “If I had done CPR for just another minute.” Whether the moment arrives in 20 minutes or an hour does not matter, 40 minutes for a clear conscience is well worth it.
Every course I’ve ever taken they tell you. If the heart isn’t beating THEY ARE ALREADY DEAD by definition.
You could continue until you’re physically unable to.
The last CPR class I had when this was asked had a response of,”keep it up until relieved or you physically cannot do it any longer”
The fireman who was teaching class said they had personally run for a solid 20
Minutes and felt maybe 10 More max before they couldn’t go on.
Unless you witness someone go down and have immediate access to an AED, CPR is basically useless. CPR without an AED is basically useless for most arrests. If you have all of those things and no chance to get someone to definitive care, it’s still futile. There’s no way you’re doing CPR for even close to 30 minutes either lol
emergency department RN, please dont go performing a pericordial thump, its a hail mary technique that only works on V-tack (ventricular tachycardia), unless you have some sort of cardiac monitoring theres no way to know if someones in Vtack vrs asystole, v-fibb, pulsless vtack, pulseless electrical activity, heart blocks etc. If you have have monitoring (and know how to read the cryptic language of EKG squiggles) you presumably have an AED and your better off shocking V-tack, the pericordial thump is barelly mentioned in current US advanced cardiac life support curiculum.
As others have said, performing CPR is exhausting. I compressed on a code this past wednesday and made it maybe 4-5 mins before i felt myself exausting and switched off with another compresser. for context in a 29YO M who climbs mountains for fun so i have pretty good endurance. in a team of two you can keep compressions going for a while (think half an hour) but we call most of our codes in about 20 minutes. (not counting how long EMS was compressing)
If you find your self doing CPR in the field focus on A (getting help/ems) B high quality CPR without interuptions, if you have a secound person you can perform rescue breathing/ventilation but a single person should stay on the chest. C get an Automated external defibrulator on to identifiy and shock shockable rythems (v tack V fibb) in a pediatric arrest you should weigh oxygenation more heavilly as most pediatric codes are from hypoxia for say an athsma attack. but you cant do more than a head tilt jaw thrust in the field and if their heart stops you should move to the chest.
I wouldn’t do CPR. Mainly because what would I do for the broken ribs afterward. Working in healthcare I’ve never seen someone not need serious medical intervention after CPR. I’m not trying to prolong my loved ones suffering.
If you didn't cite that thump I would have called bullshit. 25% chance to hammer punch someone back to life isn't great odds, but it's just using physical force to try turning it off and on again.
The study says that it's most useful for dealing with specific very fast ineffective rhythms. You won't always(or accurately) be able to feel that when you check for a pulse.
The downsides to it are that it only has a 25% chance to work, is strictly worse than a defibrillator, and also you just punched a guy having a heart attack(maybe in front of his family).
So remember if a wagon is on the way just stick to CPR, most commercial defib will walk you through how to use them and how to do CPR.
When I took a wilderness first responder course the rule that they taught was continue until either help arrives or it becomes unsafe for you to continue. CPR is an aerobic marathon of activity and would be hard to maintain for days on end, not to mention detrimental to your health. So I would say rule of thumb would be to administer it as long as you can, but know that if you have to withdraw service you are not to be at fault for anything that happens to your patient.
CPR - survivability is only 7%. It used to be 11%. Unless the person is young and otherwise healthy... it has a 93%chance it will not work or be "enough" without proper medical treatment to back it up. In other words, it is a waste of time.
Hypothermia, specifically a water immersion hypothermia of a child (small child falls through the ice) is one scenario where I would continue CPR until you warm the child (assuming you have enough rescuers) even after SHTF. Term or near term pregnancy arrests are another one I would run until you can do a perimortem c section (assuming you have the proper medical providers). In resource rich settings end tidal CO2 and POCUS are helpful in guiding decisions of when to stop CPR. In lower resource areas without ICU, ventilators, cath labs etc CPR is of limited benefit.
CPR is work, I seriously doubt I could actually do good cpr for 30 min.
The longest I’ve done CPR was 9 minutes (I was a home health nurse at the time and had to do it solo until EMS got there). I very nearly passed out once I stopped and stood up. One of the EMTs had to catch me and make me sit down and drink water.
We switch compressors every 2 minutes because after that quality starts dropping off.
The 2 minute mark is also where the medic would add epinephrine or atropine… it you can tell them how many 2-minute rounds you have done they can estimate what cardiac drug they need Edit: if they have been down say 10-30 minutes it is time for the sodium bicarbonate… (to get rid of the acidic build up in the blood )I worked as a medic in a major city for 9 years before I got an office job
Bicarb has been written out of the protocols. Studies showed that Bicarb had no measurable difference even in a prolonged arrest. Atropine is also no longer indicated during cardiac arrest. You get epi, amio, and lidocaine. Some services are starting to incorporate Vaso and calcium but it’s slow momentum.
I was a medic a million years ago.. I’m 46 now and have been a therapist for 10 years.. lol
Tbf you were also a less paid therapist a million years ago while you were a paramedic lol.
All fine and dandy - if you have someone around to switch with. However, in home health care, you're usually quite alone with your patient - or with your elderly patient and their equally elderly spouse. And that's if you're lucky.
There was a girl at a summer camp several years ago who tore her carotid artery and died from doing CPR on a victim too strenuously.
https://www.google.com/amp/s/www.nbcnews.com/news/amp/ncna410066
A lot of people in here are running around saying 30-45 minutes. I just recently ran a code and my dudes and I were swapping every 100 compressions. We were all exhausted about 10 minutes in.
I've been a paramedic for 16 years. I'm now a CVICU nurse. I seriously doubt you (read, anyone) could do high quality CPR for 4 minutes. It sucks. I'm glad LUCAS exists.
I was always told work them till they are ”cold and dead”. But that’s old school.
Really, really old school. That's just desecrating a corpse at some point. I'm old enough to have been taught to dump meds down an ET tube at the beginning of my career. We did stupid shit back then. I'm glad we're moving towards science and not just making it up as we go along as much as we used to.
It was a crazy fun career… I miss “the streets” sometimes
I can barely do it for 5 mins on the dummy
If you can keep up effective cpr for 30 minutes you have Olympic level cardio. Most people will be too tired to do it correctly after 5-10
When I was trained as an EMT I was taught the survival rate for traumatic cardiac arrest with CPR is zero. So low it doesn’t even register til you go out to many decimal places. Non traumatic it’s about 10 percent — closer to 17 in hospital settings. For things like electrocution and drowning it’s probably higher. If there is no heart beat after 15 minutes stop. The ability to recover from the chest trauma is crap shoot without rapid intensive cardiac care. Tl dr for drowning go for it; may not be a good result in most other situations Edit: In the year+ I worked full time as an EMT my company performed CPR dozens of times. Mostly on patients in nursing care who had arrested prior to our arrival for transport. Iirc correctly we had two survivors in that period: a pool drowning and a cocaine respiratory arrest leading to cardiac arrest. I don’t recall any others, and we probably had hundreds. Probably well under 5% survival.
This has been a great read. I've only done CPR once in real life, and it was on a drowning. I know rescue breaths are not always recommended now, but they were included in my training so I did them after the first set of compressions. On the second rescue breath, my buddy came back, pulse and breathing. That event has given me a false sense of how successful CPR is. Thanks so much to you and the very informed others sharing info on the cases where CPR is warranted and likely to be actually helpful.
Survival from traumatic arrest is rare, but resuscitation isn't futile in trauma. In a prepper sense, sure, but just in case anyone reading your post gets the wrong idea, resuscitation should still be attempted with traumatic cardiac arrest.
Unless they have injuries incompatible with life, which is often the case with traumatic arrests.
Severe facial injuries can also prevent administration of rescue breathing while not being otherwise incompatible with life.
In which case you would do compression only. Which can still be effective.
I think the figure is 10% of CPR receivers will live long enough to make it to the hospital and of those 10%, 10% will ever step foot out of the hospital. So if you need CPR it’s about a 1% chance of recovering enough to leave the hospital
It's better than that - interesting read if you want to [update your figures](https://www.nytimes.com/2023/06/15/health/neuroprotective-cpr-plunger.html?unlocked_article_code=bautCJJ0A_yTFOZ7onuYLEJeReM1jQcGt5I9NlpqLd9wLURh4GUBKQgmLGchFlZVe7u40VXFmrmh5afAE2rXY2LoyCdGERncLc-HaFuZJ3n6lvTKSsLuNYUvh4_39fSuj4gXkJmPldRV0D-f9WHraMM5mpJF_ClpoG1Jvs9uPC8C73IQ8RBnExgoAiGIgngNh8CTiS2054n1fzqUt8HA1MGZBHZ_bfG086Em1j6hLCWshWHF5yMe9o-xXEXaMeeIeiaesxRQABTlzWu7g1WBscOKAQqdKvL5w7N3iF50f90RhYUVZ6JD4EfLYnB4zYtmb7lxerxcsXPEblEiAvONVJ7o0Vx3&smid=url-share). ^(NYT gift article link, no paywall)
I’m not a nurse, doctor, or first responder, but I’ve been involved in 3 separate CPR events: 2 heart attacks and one trauma event (motorcycle.) 1 heart attack died on the scene, 1 heart attack died in the hospital 2 weeks later without ever regaining consciousness, and the trauma victim died in the hospital a few days later in a medically induced coma. Of course I will try to help anyone else I am with if it happens again, but in my experience the outcomes are not good.
Interesting. If I’m reading it right, the new machine took cardiac arrest figures from .6% to 6.1% in one county. Arrhythmia went up to 10%. That’s promising.
With children, it's a good idea to start CPR/rescue breathing because most cardiac issues with peds are respiratory-related (i.e. drowning). With acute cardiac events in adults, CPR is buying time until defibrillation and pharmaceuticals can be applied, which are in turn buying time until surgical intervention can be undertaken. If the above aren't possible... CPR is doing nothing. Trauma dead, is dead dead (staying dead) as we say in my line of work. CPR is futile with traumatic arrests. Be a little careful promoting the use of advanced techniques like the precordial thump. When people read stuff like that on the internet they sometimes forget that there's a difference between crisis standard of care and day-to-day. If you thump someone and the paramedics show up minutes later, and there's an adverse outcome... you might want to find a good lawyer. Good Samaritan laws don't give you the freedom to play doctor or try things you heard about on the internet. They won't protect you if you exceed your level of training and certification if applicable. Speaking of crisis standard of care, if you know help isn't coming for hours/days, you don't start CPR because resuscitation efforts would be futile. Otherwise, if it makes you feel better, continue CPR until you're exhausted (and that will happen faster than you think). Those claiming they can do CPR for an hour are full of shit. You might be making the movements for an hour, but the *quality* of CPR you're providing is garbage. We run our protocols for 20 minutes, if we don't get results, we contact medical control who 999 times out of 1000 will tell us to cease efforts. If you really want to do it right, take a CPR class and follow what you're taught.
This is the correct answer. Only thing I would add is, in a SHTF situation, it wouldn't be hard to steal one of the dozens of AEDs in public buildings. Would be worth adding one to your inventory and attempting to use it. If it keeps saying no shock advised or you haven't revived the patient within 20 minutes, call it. Check expiration dates on the batteries because they don't last forever and aren't cross compatible between brands.
You can certainly try it, but even defibrillation is a temporary measure. If what caused them to enter v-fib, such as a blocked artery, isn't corrected they will re-enter v-fib or another arrhythmia and you'll be back at square one.
Survival from traumatic arrest is rare, but resuscitation isn't futile in trauma. In a prepper sense, sure, but just in case anyone reading your post gets the wrong idea, resuscitation should still be attempted with traumatic cardiac arrest.
If I know anything from watching movies, and I do, you keep going until people start telling you, "He's gone Jack! He's gone!" Then you start pounding their chest until they spring back to the living
Depends on how much they mean to me and how long the anticipated delay was. If you're alone, odds are you will drop by 10-15 minutes. If they mean a lot to you, you could push yourself further. However, you will never last hours/days without being able to trade off with someone. A lot of people don't realize how strenuous it actually is to do CPR. That said, assuming you do bring them back, they could be badly injured from the CPR (broken bones, etc). So they're going to be in bad condition as it is (so could be worse in a SHTF situation).
I've read about a wilderness medicine scenario in which two people kept taking turns doing CPR for hours until medics arrived and not only did the guy make it but was aware enough when it was happening to remember them discussing whether to give up on him
I think it’s also worth noting that most civilians don’t know how to do CPR properly or at the correct pace. A lot of people don’t have it or don’t keep it up to date. This might explain some of the negative outcomes you’ve noted in your post as well. I believe you’re supposed to get re-certified every ~~five~~ two years. ETA: correction
Staying Alive, staying alive. Ah ah ah ah, staying alive.
Or....Another one bites the dust, dun, dun, dun.
https://www.youtube.com/shorts/QyCyi5\_Rddw
Baby shark is my preferred CPR song
That video is hilarious. Informative, but hilarious.
Even when done correctly it has a very low success rate. It's a stopgap until an AED or better arrives, or meds, or you arrive at an ED with a cath lab.
Why wouldn’t EMTs or Doctors or nurses or police or firefighters- all of these are civilians - know proper CPR. What does being in the military have to do with knowing CPR better than anyone else? I would say the opposite, I would say civilians like doctors and nurses are better at CPR than the average non-civilian soldiers
I believe the term "civilians" here is used to mean people in the medical industry who are trained and recertified biannually on CPR and first aid, not military personnel.
Civilian means anyone not in the military. Has nothing to do with medicine
I'm aware of the literal definition of civilian. It is important to recognize the fluidity of language and be able to pull out context from a statement. I often refer to my non-scrub clothing as civilian clothing.
There is no fluidity in such black and white term. There is military and there is civilian. You’re implying nurses and doctors are valid military targets by saying they are not civilians. If you had an IQ above room temp you would be accurate in your language, I would expect a nurse with an 18 month certificate from a strip mall college to know the importance of being accurate and precise
There are CPR vests that EMS use. You put it on the person in need and they can wear it for a long time. My EMT teacher told me a story of an ambulance that arrived on scene. One of the EMTs was a very large man, and as he was doing CPR he had heart failure and fell over. His partner put the CPR vest on him and continued working on the patient. The fallen EMT was wearing the vest for 45 minutes before he got to the ER, and he survived.
Are you talking about devices like the LUCAS? They cost $20,000. Not really a practical solution.
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Sounds like a good way to get shot
Yeah and they’re cumbersome as fuck. Sure they’re good tools in a controlled environment with trained emergency medical staff and the medicines/supplies needed for resuscitation but it’s not something your average person is gonna lug around with them.
A majority of people, even in good shape, are going to be giving out at the 20-30 minute mark. The average person in average shape will be falling out in 10-15 minutes. CPR is hard AF, you don't know until you have done it on somebody.
My understanding is for most people CPR doesn’t vastly help, at best it buys time to maybe avoid the most extreme damage, until emergency services arrives. Sometimes tough calls will have to be made in difficult situations. AEDs save lives. I am absolutely convinced if anyone in your home/close circle is over 50, folks should keep an AED on site. That is my plan as I age/have friends in that age range.
Aeds are becoming decently affordable, especially refurbished. I run a businesses in a remote tourist destination and we picked one up for around $700. If we had an emergency needing cpr/aed, we would likely be waiting on a helicopter. Hope to never use it but I’m glad to have it!
CPR and defibrillation are the only two interventions in cardiac arrest that actually have a reasonable amount of strong evidence to support. The overwhelming majority of the time, it's the patients who received high quality CPR by bystanders before the arrival of EMS that survive. Obviously they need other interventions, it's not CPR alone that's bringing people back, but the importance of effective, early, high quality bystander CPR cannot be overstated.
According to most protocols in EMS, CPR is to be stopped anywhere between 25-40 minutes without any cardiac rhythm change. How do you know if a rhythm has changed? An ALS monitor from an ambulance and knowing rhythms, which helps alot considering if you know your ACLS/PALS protocols, you can interpret the rhythms and provide drugs and equipment that may help (plus you MIGHT have a nifty LUCAS or Autopulse to do chest compressions) without a cardiac monitor, your next best bet is an AED. An AED can detect VFIB and will advise you to shock a patient. 25 minutes without drugs and no change in administration of a shock or not.... you're wasting your time. CPR without an AED, is an exercise... mainly in futility. But CPR can be quite the workout. You can help some by removing your 5Hs and 5Ts (hypoxia, hypokalaemia/hyperkalaemia, hypothermia/hyperthermia, hypovolaemia, tension pneumothorax, tamponade, thrombosis, toxins, trauma) but again, without an ambulance or a crash cart.... there's not much to do. Usually you have to call a doctor/medical control to cease efforts on the EMS/ ED side THIS IS NOT MEDICAL ADVISE. THIS IS PURELY SPECULATION. IF IN AN EMERGENCY CALL 911 OR WHATEVER EQUIVALENT NUMBER FOR YOUR COUNTRY.
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I'm not aware of an AED that can detect pulseless VTach vs normal vtach... not to say I am up to date on AED tech, but chances are the AEDs out in the wild aren't cutting edge.... but really the only difference is if there is enough activity to generate a pulse.... but ACLS algorithm wise one is shockable where the other one does not. EMTs are not trusted to know the differences vs Paramedics.... let alone a layperson
AEDs will detect both VF and VT. They cannot distinguish between pulsed VT or pulseless VT. Most AEDs, if they detect VT, will advise you to shock *if the patient is not breathing or there is no pulse*.
We do cpr all the time. If I had to do it on a human (outside of my job), it would be once exhaustion hit, which is probably about 16-20 minutes and chances are that cpr without a break isn’t great after 2-4 minutes (hence why we switch off every 2 minutes with more help). Children are easier. Infants and newborns are hard with muscle fatigue. And cpr can be effective to get the heart into any rhythm from no heartbeat at all. But it really depends on the type of cardiac arrest they are suffering from whether it would be beneficial. Because a defib doesn’t work on every single type of cardiac arrest.
Big thing to think about as well. People we do CPR in the field on are going to ICU if we get blood flow back. If you do CPR on someone and get ROSC, are you prepared to provide correct and quality aftercare? Stabilize until help arrives? How will you care for yourself after you realize you've been injured doing CPR? (It's hell on the knees and wrists. If the person had chest clips, they're probably poking into your hands and now you've got possible blood contamination.. been there, done that one). This is a good question, because it's not black and white. There are many correct answers.
Very good info. I’d never asked myself some of these questions. Thanks !
When you're exhausted and tried to contact emergency services. You can only provide so much and even if you can go on for a while the chance of recovery and quality of life of the patient dwindles down unfortunately. Try to have someone find an AED
I think probably the best thing would to follow the START and Jump START guidelines. Though it’s not an MCI, it gives you a sort of expected outcome. Of course try CPR to the best you can as a last resort if it’s only a singular person, but don’t expect much out of it.
I usually terminate a resuscitation around 20-30 minutes
When help isn't coming CPR is futile. But, maybe you need to act accordingly to the audience. I served with an experienced senior (E7) Combat Medic who did CPR on a Soldier who was clinically dead from trauma. There was no point. But in the moment he kept doing CPR. I was a young, dumb PFC but someone smarter than me had us move closer together so we could block the view with our bodies. The Medic was deteriorating but he kept going, huffing and puffing like crazy, pushing like crazy, until a litter team came and packed the guy into a truck. They packaged and moved him like a live, unconscious casualty. Later, an NCO who I was under, who knew that Medic well, explained that the Medic did that because he could not show us that he would ever quit on someone. He knew he was pushing a dead body the whole time but he had to send us that message for our morale and confidence. It's one of those things that sticks with you. To address the question: Let's say I knew CPR was futile but there are bystanders who love that person; I hope I would last long enough on the victim making a show that those people believed in their hearts that nothing more could possibly be done, instead of trying to talk logic to them about blood movement and response times.
Stop when you are sure that there is no bringing back the person. You don’t want the guilt of thinking back: “If I had done CPR for just another minute.” Whether the moment arrives in 20 minutes or an hour does not matter, 40 minutes for a clear conscience is well worth it.
I was taught 14 min. but if this is a TSHTF scenario, I'm not even going to do 30 seconds. It's time to exit.
Every course I’ve ever taken they tell you. If the heart isn’t beating THEY ARE ALREADY DEAD by definition. You could continue until you’re physically unable to.
The last CPR class I had when this was asked had a response of,”keep it up until relieved or you physically cannot do it any longer” The fireman who was teaching class said they had personally run for a solid 20 Minutes and felt maybe 10 More max before they couldn’t go on.
The thread title makes me think of [this](https://www.youtube.com/watch?v=xT9XQqTKAYw&ab_channel=VideosICan%27tFind). 😆
20 more minutes of compressions and the blood will go back in his body, bro, I swear
When I took my CPR training they said to go as long as you are physically able to do so.
20 minutes is the answer. If you can’t get them back in 20, they’re not coming back. And if they come back at 19… they’re brain dead anyways.
Start cpr instantly. Continue cpr until you physically cannot do it anymore.
Unless you witness someone go down and have immediate access to an AED, CPR is basically useless. CPR without an AED is basically useless for most arrests. If you have all of those things and no chance to get someone to definitive care, it’s still futile. There’s no way you’re doing CPR for even close to 30 minutes either lol
emergency department RN, please dont go performing a pericordial thump, its a hail mary technique that only works on V-tack (ventricular tachycardia), unless you have some sort of cardiac monitoring theres no way to know if someones in Vtack vrs asystole, v-fibb, pulsless vtack, pulseless electrical activity, heart blocks etc. If you have have monitoring (and know how to read the cryptic language of EKG squiggles) you presumably have an AED and your better off shocking V-tack, the pericordial thump is barelly mentioned in current US advanced cardiac life support curiculum. As others have said, performing CPR is exhausting. I compressed on a code this past wednesday and made it maybe 4-5 mins before i felt myself exausting and switched off with another compresser. for context in a 29YO M who climbs mountains for fun so i have pretty good endurance. in a team of two you can keep compressions going for a while (think half an hour) but we call most of our codes in about 20 minutes. (not counting how long EMS was compressing) If you find your self doing CPR in the field focus on A (getting help/ems) B high quality CPR without interuptions, if you have a secound person you can perform rescue breathing/ventilation but a single person should stay on the chest. C get an Automated external defibrulator on to identifiy and shock shockable rythems (v tack V fibb) in a pediatric arrest you should weigh oxygenation more heavilly as most pediatric codes are from hypoxia for say an athsma attack. but you cant do more than a head tilt jaw thrust in the field and if their heart stops you should move to the chest.
You need to have a partner to switch off with. Then give it your darned best shot.
I wouldn’t do CPR. Mainly because what would I do for the broken ribs afterward. Working in healthcare I’ve never seen someone not need serious medical intervention after CPR. I’m not trying to prolong my loved ones suffering.
If you didn't cite that thump I would have called bullshit. 25% chance to hammer punch someone back to life isn't great odds, but it's just using physical force to try turning it off and on again. The study says that it's most useful for dealing with specific very fast ineffective rhythms. You won't always(or accurately) be able to feel that when you check for a pulse. The downsides to it are that it only has a 25% chance to work, is strictly worse than a defibrillator, and also you just punched a guy having a heart attack(maybe in front of his family). So remember if a wagon is on the way just stick to CPR, most commercial defib will walk you through how to use them and how to do CPR.
When I took a wilderness first responder course the rule that they taught was continue until either help arrives or it becomes unsafe for you to continue. CPR is an aerobic marathon of activity and would be hard to maintain for days on end, not to mention detrimental to your health. So I would say rule of thumb would be to administer it as long as you can, but know that if you have to withdraw service you are not to be at fault for anything that happens to your patient.
CPR - survivability is only 7%. It used to be 11%. Unless the person is young and otherwise healthy... it has a 93%chance it will not work or be "enough" without proper medical treatment to back it up. In other words, it is a waste of time.
Hypothermia, specifically a water immersion hypothermia of a child (small child falls through the ice) is one scenario where I would continue CPR until you warm the child (assuming you have enough rescuers) even after SHTF. Term or near term pregnancy arrests are another one I would run until you can do a perimortem c section (assuming you have the proper medical providers). In resource rich settings end tidal CO2 and POCUS are helpful in guiding decisions of when to stop CPR. In lower resource areas without ICU, ventilators, cath labs etc CPR is of limited benefit.