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When CPR Is the Wrong Call: Mistaking Medical Treatment for Care

March 14, 2013

If a medical treatment worked only a fraction of the time and resulted in bad outcomes more often than not, practitioners would not make this treatment the default approach. Yet that is exactly what has happened when it comes to CPR for individuals 85 years and older who suffer cardiac arrest in a community setting.

In a recent op-ed in the Los Angeles Times, Kevin M. Dirksen and RAND's Neil S. Wenger explain that, like heart surgeries and joint replacements, CPR should only be performed on elderly patients when and where it is appropriate:

“Studies of CPR performed on individuals 85 years and older who suffer cardiac arrest in a community setting show that few—perhaps 4 in 100—survive to leave the hospital, and the majority of these 'survivors' are moderately to severely neurologically compromised. For the small number of elderly patients who survive the ambulance ride to the hospital and then make it through the emergency room to be admitted to the intensive care unit, treatment is nearly always burdensome, including being attached to life-sustaining machines. Only rarely does such treatment yield continued life meaningful to the patient.”

Dirksen and Wenger go on to highlight the importance of advance directives, documents that allow patients to make informed decisions about their medical treatment ahead of time.

— Pete Wilmoth