CPR Risks for seriously ill: Things to consider when discussing advance directives

It may come as no surprise that Hollywood movies portray CPR (cardiopulmonary resuscitation) unrealistically. The plot usually plays out with EMS arriving on scene, quickly administering 15 seconds of CPR, a patient gasps for air and suddenly awakens. Unfortunately, the harsh reality is those who survive CPR can face a difficult recovery, especially those with a serious illness.

When discussing advance directives and medical wishes it’s especially important for seriously ill patients to consider the risks associated with CPR. Talking to your loved ones about this topic may not be easy but it will help them understand what is important to you and why, while also helping them support you and your decision.

What is CPR?
CPR is a procedure used when someone has suffered cardiac arrest (sudden stoppage of their heart). It is an attempt to restart the heart and breathing, and it includes pressing hard on the chest and may include mouth-to-mouth or mask breathing. It may also involve using electrical shocks to attempt to get the heart to beat correctly, insertion of a breathing tube down the throat, and giving intravenous (IVs) medications.

Risks of CPR:

• If you have a serious illness, CPR is unlikely to be helpful – less than 1% of people with a serious illness survive after having CPR.
• Lack of oxygen while CPR is preformed can cause significant injury to their brain or other organs. This can leave individuals depending on others for care or in a persistent vegetative state.
• CPR can break ribs and cause severe pain.
• Survivors likely face a long hospital stay and rehabilitation.
• Complications of intubation and ventilation include damage to the teeth, voice box or lungs, pneumonias or other infections, and collapsed lungs.
• Family members and loved ones of patients, who are admitted to the intensive care unit on a ventilator, are more likely to develop PTSD.

How do I make my wishes known?
Whether or not you choose to receive CPR, the best decision you can make is to discuss your healthcare wishes with both your family and care provider. Thinking about your healthcare wishes for the future will give you more control over the care you receive.

It is important to make your wishes known in writing. If you do not document your wishes in writing, emergency personnel have been trained to start CPR and documenting your decisions will ensure anyone involved in your care knows what your wishes are – easing the burden on your family in the event you can’t speak for yourself.

For more information about advance directives and how you can make your healthcare wishes known, contact HopeWest at (970) 241-2212.

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