Do you end up as a closet plant after CPR?
The number of Dutch people who do not want to be resuscitated is increasing rapidly. Many are afraid of ending up as a greenhouse plant. But is that fear justified? Five common misconceptions.
1. You can easily recognize a cardiac arrest
You often see it in movies. Someone grabs the chest area and then falls lifeless to the ground. The reality is different. Cardiac arrest can look like an epileptic seizure, with limbs suddenly cramping and constricting. Sometimes the fingers come into a forced position. It is also possible that the patient appears to have fallen asleep and is making snoring noises. Often someone gasps like a fish on dry land, with the tongue protruding a little from the mouth.
This type of body reflexes is a sign to rescuers that the patient needs to be resuscitated as soon as possible. At such a moment there is often a case of ventricular or ventricular fibrillation. The heart then only makes very fast chaotic movements and does this so uncontrollably that there is no longer any question of blood circulation. These movements slowly fade out as time goes by.
People usually speak of a cardiac arrest, but that is actually not true. The heart still makes movements, but there is no longer an effective pumping movement. That is why doctors speak of a ‘circulatory arrest’. Thirty to one hundred and twenty seconds after a circulatory arrest, a respiratory arrest occurs. It may take some time for the heart to come to a complete stop.
2. With chest compressions and artificial respiration you bring someone back to life
Unfortunately, chest compressions in combination with artificial respiration are not enough to wake someone up again. The only effective treatment is to give an electric shock, also called defibrillation.
Most sports clubs, restaurants, swimming pools, shopping centers, stations, hotels and office buildings in our country have an AED: an Automated External Defibrillator. It must be used as soon as possible, because the longer it takes for the heart rhythm to return to normal, the greater the chance of permanent damage. The AED itself indicates whether the person in question benefits from one or more electric shocks. There is then a so-called ‘shockable rhythm’. This is the case with ventricular or ventricular fibrillation. The AED will also indicate when you should start chest compressions and ventilation again, in between shocks. This is important, because by pumping on the chest you ensure that oxygen-rich blood goes to the heart and brain.
3. The chance of survival in the hospital is greater than if you suffer a cardiac arrest at home
Someone who is admitted to a hospital and goes into cardiac arrest there immediately has doctors and nurses around him. So you would think that the chance of surviving a cardiac arrest is greater there. Yet that is not so. If you are in a hospital, something is already wrong. A cardiac arrest is then in many cases a sign that the body is ‘used’.
For example, people who suffer cardiac arrest on the street will generally be healthier than people who are in hospital. As a result, they have a better chance of survival. How much better is unknown.
4. If you survive CPR, you will end up as a greenhouse plant
Although CPR after a cardiac arrest is always a major event, half of the survivors suffer little or no lasting damage. The other 50 percent do have complaints after CPR. One in three needs help with everyday activities. The rest (two-thirds) can manage independently but suffer from, for example, memory disorders, concentration problems or fatigue. Research shows that peers who have not had CPR also have these kinds of problems. It is not clear to what extent the complaints are caused by cardiac arrest and resuscitation.
Figures from the Resuscitation Council and the Heart Foundation, among others, show that the risk of ending up as a greenhouse plant is very small. After out-of-hospital resuscitation, only 0.2 percent of patients enter a vegetative state.
5. If you wear a do not resuscitate badge, ambulance staff will not start CPR
A non-resuscitative medal is a legally valid advance directive, Minister Edith Schippers of VWS has stated. The same applies to a non-resuscitative tattoo and also to a written advance directive to this effect. The wearer indicates that he or she does not want CPR if it is necessary.
Nevertheless, people with such a badge or tattoo are often resuscitated in practice. This is because ambulance workers have to act as quickly as possible. Removing clothing to see if the patient has such a badge or tattoo would then take too much time. The ambulance nurse or doctor must stop the moment the no-resuscitate statement is visible. But that can only be, for example, when the rescuer removes the clothing in order to apply the self-adhesive electrodes to the bare chest. The chest compressions and ventilation have usually already taken place.
Most cardiac arrests occur at home. If you absolutely do not want to be resuscitated, it would be a good idea to make this known to family members, neighbors and the GP.
Sources):
- Plus Magazine
