Performing CPR (Cardiopulmonary Resuscitation) is a significant intervention that can alter people’s lives. With such power in your palms, it’s really important to understand how to yield it correctly. The first thing to understand once you receive your CPR certification is that there are instances when you shouldn’t put this knowledge to use.
So, when should you not perform CPR? Believe it or not, sometimes CPR can do more damage than good or land you in legal trouble despite your best intentions. The ability to make informed decisions and impartially assess the appropriateness of CPR based on specific circumstances is just as crucial as having the knowledge and practical skills to administer it.
Read on to learn when withholding CPR is the right thing to do!
What is the Purpose of CPR?
Before delving into when exactly you need to refrain from performing CPR, it’s essential to understand the purpose behind this procedure. Cardiopulmonary resuscitation techniques aim to manually assist the circulation of blood and oxygen throughout the body when a person’s heart cannot function as intended.
A crucial thing that becomes clear during CPR certification courses is that the main purpose of CPR is to keep someone alive until medical professionals arrive on the scene to take over.
During CPR, you’re basically standing in for the victim’s failing heart, pumping the blood throughout the body via compressions and delivering oxygen to it via rescue breaths. Expecting it to work as it does in the movies isn’t a realistic outcome, particularly in terms of how long it takes to resuscitate someone.
Factors to Consider Before Performing CPR
While CPR can be a life-saving procedure, not every situation demands the administration of the techniques. The decision to administer CPR shouldn’t be automatic. You need to stay calm, keep a clear head, and carefully evaluate the circumstances you find yourself in.
Factors such as someone’s medical history, whether or not advance directives are in play, and the potential outcomes of administering CPR are just a few examples of things you need to keep in mind. CPR is an invasive and burdensome procedure, and you need to realize that since it clearly shows that it may not be the method of choice in every emergency situation.
Watch for Advance Directives
Advance directives refer to legal documents that some individuals, mostly elderly or chronically ill people, may have in place. These directives clearly state their wishes regarding end-of-life interventions like CPR. Healthcare providers use such directives as guides when making decisions about administering medical interventions to someone in clear need of them.
If a person has an advance directive in place that specifically states they don’t want CPR, you must respect their wishes and refrain from performing it. The directive must be displayed clearly, though, and there are also Samaritan Laws to protect you in case you miss it. However, if you’re aware of the directive, you’re bound to respect it.
Evaluate the Victim’s Condition
When determining whether or not to administer CPR, you must consider the patient’s overall condition and prognosis. CPR is most effective when there’s a reasonable chance of full recovery. If an individual is already in a terminal stage of illness, CPR might do more harm than good.
Examples include patients who are suffering from late-stage cancer or those who have a poor prognosis even if CPR is administered. Focusing on providing comfort care and a peaceful end-of-life experience is more appropriate than trying to perform CPR over and over again.
Signs of Life
The one thing that you always need to be looking for is signs of life. The victim who was unresponsive when you began administering CPR might start demonstrating signs of life, in which case, you must cease the CPR protocol immediately.
The signs of life in question are indications that the heart and lungs have regained function, manifesting as regular breathing and a heartbeat. When signs of life are present, performing CPR techniques is actually counterproductive and may put the victim in a more dire state once again.
Risks and Benefits
Given the somewhat violent and strenuous nature of CPR, performing the techniques isn’t risk-free. CPR is physically demanding and may lead to fatigue, particularly for untrained individuals performing it for the first time ever. Stress, which you’ll surely experience when administering first aid to someone in critical condition, only exacerbates this aspect of CPR.
If you burn out during CPR, you can compromise the effectiveness of the procedure and even cause harm to yourself. Weighing out the risks and benefits of CPR is extremely important when gauging whether to keep going or discontinue the procedure.
Scenarios When You Should Definitely Not Perform CPR
While the decision to perform CPR is nuanced and depends on individual circumstances, there are specific scenarios where CPR may not be appropriate. It’s essential to recognize these situations and make informed choices accordingly.
- Irreversible Traumatic Injuries. Some situations are clearly beyond the scope of administering CPR in regard to keeping someone alive until emergency services can take over. For example, in cases of decapitation or amputation of the torso, performing CPR is obviously useless.
- Dangerous or Unsafe Environments. Attempting to perform CPR in an unsafe environment isn’t going to be effective and might put both your life and that of the victim at risk. In circumstances with clear threats to your life, like exposed power lines, highway car accidents, or ongoing violent exchanges between individuals or groups, you shouldn’t approach a victim until the scene is secure.
- Signs of Obvious Death. This is a tricky one as most courses indicate that a person without a pulse and detectable breathing is the one to prioritize when administering first aid. These signs include rigor mortis, lividity, and loss of temperature.
Rigor mortis refers to the stiffening of the muscles after death, typically occurring a few hours post-mortem. Lividity is the pooling of blood in the lowest parts of the body since there’s no longer circulation to keep the blood from moving.
- Emergency Medical Service (EMS) Arrival. Once medical professionals are on the scene, you don’t need to perform CPR anymore, but you shouldn’t just abruptly stop, either. Clear communication is vital when transferring the victim’s care to the paramedics.
Final Thoughts
When faced with a situation where you’re uncertain whether or not to perform CPR, the correct decision is to try and help. Since the answer to the question of when you should not perform CPR isn’t straightforward in most cases, learning the situation where CPR is useless or, worse, counter-productive is an integral part of understanding the methodology.
Evaluating the individual’s condition, the emergency circumstances, the possibility of advance directives, and considering the limits of CPR are crucial components of this decision-making process. By enrolling in our CPR certification course in Charlotte, you’ll gain a thorough understanding of the scenarios in which you shouldn’t perform CPR.