Let’s take a look at what happens if someone you’re performing CPR on dies. According to research by the American Heart Association, 90% of out-of-hospital cardiac arrests are fatal, despite CPR being provided. Failure of CPR is a very common occurrence, but this doesn’t make it any easier for the rescuer with the CPR Certification.
If you have administered CPR and the patient still died, you should know that the unfortunate result is not on you. Read below to learn everything you need to know about CPR, what happens if it fails and how you can cope with it.
What Is CPR?
CPR, or cardiopulmonary resuscitation, is a procedure performed in cases of emergency when the heart stops beating and there is no pulse. It is performed by chest compressions and artificial ventilations with the end goal of delivering blood to the brain, thus preventing biological death.
How to Perform CPR
Before you start CPR, call 911. To properly administer CPR, first, check if the person is breathing. If not, start CPR by compressing the chest 30 times at the rate of 100-120 a minute, and then administer two rescue breaths.
AHA suggests that these compressions be around 2 to 2.4 inches deep. Continue this procedure until the emergency department arrives. However, note that this applies only to adults and kids above 1 year.
The ratio for infants is the same, but the compression changes to the “Two-Thumb Technique”. The depth of compressions should be approximately one-third the depth of the chest, which is around 1 to 1.5 inches.
The American Heart Association lists CPR as one of the 6 links in their Out-of-hospital Chain of Survival. The other links include:
- Recognition of cardiac arrest and activation of the emergency response system.
- Early cardiopulmonary resuscitation (CPR), focusing on chest compressions.
- Rapid defibrillation.
- Advanced resuscitation by Emergency Medical Services and other healthcare providers.
- Post-heart attack care.
- Recovery (including additional treatment, rehabilitation, observation, and psychological support).
CPR Success Rates
Contrary to popular belief, CPR is not always successful. In fact, the Emergency Medicine Journal conducted research that showed that the rate of survival for cardiac arrests that occur outside hospitals (and those in them) is much lower than believed. The participants involved in the research thought CPR was effective around 75% of the time.
However, this is not to say that CPR doesn’t help. This is still a life-saving technique that can double or triple someone’s chances of survival, especially if given immediately after cardiac arrest.
Some factors that may cause the failure of CPR are:
- Pre-existing conditions such as pneumonia, hypotension, renal failure, cancer, and a home-bound lifestyle increase the chances of CPR being unsuccessful.
- Fatigue of the rescuer.
- Stiffness of the thoracic cage of the patient.
- Soft underlying surface like a mattress which doesn’t allow the compressions to be deep enough.
What if CPR Failed?
CPR alone is not designed to save lives – it’s used to buy some time until a healthcare provider arrives or until the next step in medical care is available. Rescue breathing in CPR alone provides around 17% of the oxygen the brain needs to survive and prevent the decay of tissues, also known as biological death.
Popular culture through movies has us believing that CPR is a fix-all cure when the reality is far different. The survival rate after CPR is low, with only around 46% of people getting CPR in the first place. This is due to various factors such as waiting for the emergency medical personnel, whether a bystander had an attempt to revive the patient, etc.
Mental Health After Failed CPR
Having your CPR certification and going through a CPR attempt that fails can leave deep emotional scars. The American Journal of Critical Care found that nurses who had failed resuscitation attempts can display signs of postcode stress and PTSD symptoms.
According to another study published in BMJ Open, “Unknown or fatal outcomes often caused feelings of guilt and were particularly difficult to handle,” referring to the emotional marks that rescuers had after the administration of CPR.
These papers show the grave psychological effects on emergency medical personnel, who are trained to handle the losses of patients. For someone who is not a medical professional, this can be even harder. Coping with the loss of someone you attempted to save requires a lot of work, and it is recommended to seek advice and guidance from a mental health professional.
Another study found that emergency medical personnel merely having a debrief after the incident impacted their mental health in a very positive manner. This means that simply talking more about the situation can have a positive impact on your psychological well-being in this situation.
What is important to remember is that you are not to blame for the person’s passing. On the contrary, you were a good Samaritan and tried your best to help.
Can a person’s family sue after a failed CPR attempt? This is very unlikely, but even if it is the case, you don’t need to worry. In most cases, the verdict is in favor of the rescuer, as the court sees the attempt as a selfless act with no prospect of personal interest or gain.
Besides that, all 50 states and DC abide by the Good Samaritan laws. This law is designed to protect all those who give aid to people in danger and people with illness or injury from legal persecution. This is in place to reassure those wanting to help that they don’t need to fear legal consequences.
The Good Samaritan laws are different in each state. This means that in some states, you are legally obliged to give CPR only if you have CPR training or certification. In some states, it applies only to medical personnel, and in others, to everyone. If it applies to everyone, this means that you are obliged to administer first aid if you are capable and it doesn’t endanger you.
Some Good Samaritan laws prevent you from assisting if you are severely undertrained. However, know that this doesn’t apply to CPR.
If the person had a DNR (Do Not Resuscitate) order, this means that they do not want to be brought back to life. But in case you tried, under the assumption that you didn’t know about the DNR, you are still protected under the Good Samaritan Law.
Generally, the Good Samaritan Law consists of 4 elements:
- Permission given by the ill/injured person if possible.
- The care is given in an appropriate (non-reckless) manner.
- The person who administers the help is not the one who caused the accident.
- Care was given because it was an emergency while waiting for trained help to arrive.
Conclusion: What if Someone You’re Performing CPR on Dies?
In emergency situations, when you’re needed to act immediately, especially when it’s about saving another person’s life, you are expected to give your best. When talking about cardiac arrests, any attempt to revive the person should be done with the utmost care, especially if you’re applying CPR.
Granted, not all CPR attempts end with a positive result. However, this shouldn’t prevent you from helping someone again in the future. If you have gone through such a traumatizing incident, it’s best to first talk to a mental healthcare provider. Note that taking it a step further and seeking professional support after the incident can contribute to your well-being.