What is cardiopulmonary resuscitation (CPR)?
CPR is the combination of life saving measures performed to restart the lung (pulmonary) and heart (cardiovascular) functions in a patient who has stopped breathing and/or whose heart has stopped beating (cardiac arrest). The measures were developed to simultaneously support a patient's airway, breathing and circulation. They include: pushing down on the chest to pump blood out of the heart into the body (chest compressions), attempting to restore the heart rhythm to normal (via electric shock [defibrillation] or pacemaker), and artificial respiration using a facemask or breathing (endotracheal) tube. Medications are also given intravenously during CPR.
Is CPR performed on every patient in the hospital or ICU when their heart or lungs stop working?
In general, yes, unless a patient or family member informs the doctor that they do not want CPR. This discussion should take place between the patient or family member and the doctor prior to an unexpected event. A written order in the medical record from the doctor is required to withhold CPR. Too often the patient or responsible party and doctor do not clearly communicate about the issue of CPR. It is extremely important for the doctors and nurses to know the patient's wishes regarding CPR in the event or a heart or lung arrest. We encourage the patient and/or family to initiate the discussion regarding CPR with the doctor.
Does CPR hurt?
CPR is performed when the patient is unconscious. Therefore, it does not hurt. After CPR, patients may complain of chest pain caused by the chest compressions.
How often is CPR successful?
Many patients do not survive after their heart has stopped beating effectively. If treated immediately by personnel specially trained in CPR, chances of survival improve. For hospitalized patients, only 10-15% of patients requiring CPR survive to hospital discharge. The success of CPR depends, in part, upon the condition of the patient. CPR is most successful when the cause of the cardiac arrest is an irregular heart rhythm that is quickly converted to normal. Unfortunately, CPR is rarely successful when the arrest is due to diseases involving other organ systems that have put strain on the heart.
Because of the many factors involved with each patient, patients and families need to discuss the issue of CPR with their doctor.