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STUDIES UNCOVER SLOPPY CPR

Cardiopulmonary resuscitation (CPR) is a life saver. The technique, developed in the late 1950s by Dr. Peter Safar, is commonly known as “mouth-to-mouth” resuscitation. These days, face shields and air tubes often come between such direct contact, but no matter how it’s accomplished, CPR still relies on Dr. Safar’s original “ABCs” of resuscitation: airway, breathing and circulation.

When a victim of choking, electrocution, or drowning stops breathing, or when the heart of a cardiac arrest victim stops pumping blood, CPR can get breathing and circulation restarted. If performed properly and promptly, it can prevent brain injury caused by oxygen deprivation or it can buy cardiac arrest victims crucial extra minutes while waiting for defibrillation equipment to arrive.

While anyone can learn CPR, paramedics, doctors and nurses are the ones most often called upon to perform it. It seems only natural that these medical professionals would be adequately trained in CPR, but two recent studies have raised doubts.

Successful CPR depends on forceful compressions to the chest and correctly timed inflation of the lungs. In two studies, one conducted by the University of Chicago and the other conducted in England, Norway and Denmark, two common mistakes were found: not pushing hard enough or frequently enough on the chest, and inflating the lungs, either by mouth or with air tubes, too frequently.

Both studies used the same experimental monitoring equipment to track the quality of CPR treatment. Results were reported in the Jan. 19 issue of the Journal of American Medicine Association (JAMA). In the Chicago study, which monitored 67 adult patients, doctors and nurses failed to follow at least one CPR guideline 80 percent of the time. Failure to follow several guidelines was common. The European study monitored out-of-hospital treatment given to 176 cardiac arrest patients by paramedics and nurse anesthetists. Chest compressions were done only about half the time and most that were done were too shallow.

Does CPR training need to be more rigorous? The results of these studies indicate that it does. An even safer assumption might be that most people who have received CPR training could stand to take a refresher course from time to time. When medical emergencies strike, time runs out very quickly.

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CPR Pre-Exam

Ohio Revised Code 

§ 2305.23. Liability for emergency care.

 

		No person shall be liable in civil damages for administering emergency care or treatment at the scene of an emergency outside of a hospital, doctor's office, or other place having proper medical equipment, for acts performed at the scene of such emergency, unless such acts constitute willful or wanton misconduct.

		Nothing in this section applies to the administering of such care or treatment where the same is rendered for remuneration, or with the expectation of remuneration, from the recipient of such care or treatment or someone on his behalf. The administering of such care or treatment by one as a part of his duties as a paid member of any organization of law enforcement officers or fire fighters does not cause such to be a rendering for remuneration or expectation of remuneration.

 

		HISTORY: 130 v 648 (Eff 9-16-63); 137 v S 209. Eff 8-18-77.

§ 2133.22. Immunity in connection with withholding, withdrawing or providing CPR.

		(A) (1)  None of the following are subject to criminal prosecution, to liability in damages in a tort or other civil action for injury, death, or loss to person or property, or to professional disciplinary action arising out of or relating to the withholding or withdrawal of CPR from a person after DNR identification is discovered in the person's possession and reasonable efforts have been made to determine that the person in possession of the DNR identification is the person named on the DNR identification:

		(a) A physician who causes the withholding or withdrawal of CPR from the person possessing the DNR identification;

		(b) A person who participates under the direction of or with the authorization of a physician in the withholding or withdrawal of CPR from the person possessing the DNR identification;

		(c) Any emergency medical services personnel who cause or participate in the withholding or withdrawal of CPR from the person possessing the DNR identification.

		(2) None of the following are subject to criminal prosecution, to liability in damages in a tort or other civil action for injury, death, or loss to person or property, or to professional disciplinary action arising out of or relating to the withholding or withdrawal of CPR from a person in a health care facility after DNR identification is discovered in the person's possession and reasonable efforts have been made to determine that the person in possession of the DNR identification is the person named on the DNR identification or a do-not-resuscitate order is issued for the person:

		(a) The health care facility or the administrator of the health care facility;

		(b) A physician who causes the withholding or withdrawal of CPR from the person possessing the DNR identification or for whom the do-not-resuscitate order has been issued;

		(c) Any person who works for the health care facility as an employee, contractor, or volunteer and who participates under the direction of or with the authorization of a physician in the withholding or withdrawal of CPR from the person possessing the DNR identification;

		(d) Any person who works for the health care facility as an employee, contractor, or volunteer and who participates under the direction of or with the authorization of a physician in the withholding or withdrawal of CPR from the person for whom the do-not-resuscitate order has been issued.

		(3) If, after DNR identification is discovered in the possession of a person, the person makes an oral or written request to receive CPR, any person who provides CPR pursuant to the request, any health care facility in which CPR is provided, and the administrator of any health care facility in which CPR is provided are not subject to criminal prosecution as a result of the provision of the CPR, are not liable in damages in a tort or other civil action for injury, death, or loss to person or property that arises out of or is related to the provision of the CPR, and are not subject to professional disciplinary action as a result of the provision of the CPR.

		(B)  Divisions (A)(1), (A)(2), and (C) of this section do not apply when CPR is withheld or withdrawn from a person who possesses DNR identification or for whom a do-not-resuscitate order has been issued unless the withholding or withdrawal is in accordance with the do-not-resuscitate protocol.

		(C)  Any emergency medical services personnel who comply with a do-not-resuscitate order issued by a physician and any individuals who work for a health care facility as employees, contractors, or volunteers and who comply with a do-not-resuscitate order issued by a physician are not subject to liability in damages in a civil action for injury, death, or loss to person or property that arises out of or is related to compliance with the order, are not subject to criminal prosecution as a result of compliance with the order, and are not subject to professional disciplinary action as a result of compliance with the order.

		In an emergency situation, emergency medical services personnel and emergency department personnel are not required to search a person to determine if the person possesses DNR identification. If a person possesses DNR identification, if emergency medical services personnel or emergency department personnel provide CPR to the person in an emergency situation, and if, at that time, the personnel do not know and do not have reasonable cause to believe that the person possesses DNR identification, the emergency medical services personnel and emergency department personnel are not subject to criminal prosecution as a result of the provision of the CPR, are not liable in damages in a tort or other civil action for injury, death, or loss to person or property that arises out of or is related to the provision of the CPR, and are not subject to professional disciplinary action as a result of the provision of the CPR.

  HISTORY: 147 v H 354. Eff 7-9-98.