CPR or Not?

[triemal04]

So I came across this the other day and a couple things came to mind. First, the media are showing yet again that they are jackasses, second that Glenwood Gardens is screwed if their name pops up in the media, and third, that the paramedics in this story are also jackasses (of course that's just my personal opinion).

Before answering please fully read both links, including the fire department report.

http://www.turnto23.com/news/local-news/listen-to-911-call-from-glenwood-gardens-in-bakersfield-man-with-no-dnr-dies

https://scripps-cms.endplay.com/documents/10920/0/Glenwood+Gardens+report+for+man%27s+death/5e596d26-837c-4a94-8c19-3254cbbfaac3

But it does bring up an interesting question. If YOU responded to a skilled nursing facility (or other healthcare facility) for a patient in cardiac arrest with a valid set of advance directives that requested full care it's pretty clear what you should do. But...if the doctor who's care that same patient is under says that he has already called it AND spoken to the patient's daughter (who it would appear is her power of attorney) who requested no resuscitation be attempted, what would YOU do?

[Arctickat]

I wouldn't do anything. The patient's primary physician was on scene and had called the code at the request of the family. The physician has complete authority and responsibility in this matter. Had the physician not been on scene, then the advanced care directive prevails. Resuscitative efforts had been initiated and called by the doc, just as it would have in the hospital.

[CTaylor775]

As the poster above me stated, I would not have done anything, you have an advanced directive signed 3/5/13, the physician called it. There should not have any CPR in progress after the physician called the death. I do not agree how ever with the statement from the home stating patient was better, this information was false, it would have been better had they said, CPR was stopped because ... I do feel as though the people that are working at Glenwood Garden's need some training/retraining, so that they understand their own procedures. and when and when not to call emergency services.

[Happiness]

I agree with Akat

[scubanurse]

Craig-- I must ask, why would you start CPR?

[island emt]

Deceased pt ::: DR has declared death ::: Family is in agreement:::: = no brainer

Have the Doc sign the run report as canceling any need for your assistance.

[mobey]

Sorry, i'm not going to read the articles in their entirety, but Arcticat pretty well summed it up.

If the patients physician was on scene and states she is a DNR as per him and the patients family, that is a clear cut case for me.

Please read my signature phrase and apply it to your practice.

[Arctickat]

Ummmmm guys, an Advanced Care Directive does not necessarily mean a DNR. In this particular case, the decease had an ACD for all appropriate measures to be taken, including CPR.

[island emt]

Correct: but a physician has declared the Pt deceased. No need for any intervention from EMS

[BEorP]

As others have said, there is nothing to discuss. The patient is dead and there's nothing we need to do.