Further to my last post I was sent this link by Lianne (Thanks Lianne)
This article reports on a story in the BMJ, saying that the elderly in NHS nursing homes should not receive CPR.
Writing in the British Medical Journal (BMJ), Simon Conroy, a clinical lecturer in geriatrics, called for a review.
He said: “Given the likely low chance of success, it may be that the institution should not offer resuscitation at all.
“Resources saved by not spending time in training and the subsequent discussions could be better used in improving the quality of care.
Please note, I haven't read the full article – I may try to sneak down to Newham Hospital library to have a peek at it.
But I can see a couple of problems with the thinking from just the Daily Mail piece.
First – All NHS nurses are trained in CPR as part of their basic training. It doesn't cost much to keep those skills updated. As I wrote in the previous post, the London Ambulance Service will come out for free and teach you how to perform effective CPR.
70% of cardiac arrests happen outside hospitals, and before the introduction of defibrillators in public places the survival chance was 1%, after the defibs were in place the chance of survival was 3%.
Given the cost of Defibs, was this a worthwhile spending of money? Does the doctor who wrote the article think that putting Defibs in Tesco while removing them from nursing homes is a good idea?
Secondly – Why should we put any money into a treatment that only has a 3-6%(depending on source) success rate? If it is a waste of money to resuscitate the elderly because it has such a low chance of success, then that would apply to any out of hospital arrest.
I'm sorry, but it smacks too much of “let the old ones die” to me – and that is just distasteful. If we start heading down that route, then we may as well stop treating the unemployed or chronically ill because they don't contribute anything to the economy.
My personal view is that CPR is inappropriate in a large number of nursing home cases – but that it should be an individual choice not to be resuscitated and not the default option.
I would have like to have written more, but I'm at work and time/computing resources are limited.
UPDATE: A couple of people have sent me a copy of the article – I'll not mention any names in case it gets them in trouble – but thanks to those who helped. Once I've read it I may post about this subject again.