Are you wondering when you should not perform CPR? There are many different answers to this question. Nonetheless, doctors and experts point out specific situations when CPR has to be stopped or even completely avoided.
This is because CPR, in some cases, can complicate specific surgery, disease, and age-related risks and do more damage than good.
In this article, we’ll learn about the life-threatening aspects of the CPR procedure, how to prevent and avoid them, and settle the “when should you not perform CPR” dilemma.
A Deeper Look Into When You Should Not Perform CPR
There are many instances when you should administer CPR. For example, you can give CPR when a person suffers a sudden heart attack and has no pulse or in cases of choking, poisoning, smoke inhalation, etc.
Furthermore, you should perform the procedure when you notice that the person has stopped breathing or their heart has stopped working, the person is unconscious, or taking occasional gasping breaths.
In each of these emergencies, you’d have to approach the situation immediately and determine whether CPR is needed. However, an emergency can quickly shift and turn uncritical, in which case CPR should be stopped.
Following are some situations when you should avoid or completely stop giving cardiopulmonary resuscitation:
- When you notice signs of life (regular breathing and heartbeat)
- When the patient has a terminal illness
- When you start feeling physical fatigue
- When emergency help arrives.
Below, we provide explanation for each point and how you should approach it:
Noticing Signs of Life
If you’re still looking for the answer to “when should you not perform CPR,” the guidelines are straightforward – when you notice signs of life or the emergency services arrive. Furthermore, according to AHA’s guidelines, you shouldn’t check for a pulse for more than 10 seconds.
This means you should continue with fast, hard, and uninterrupted chest compressions until you notice the signs of life. The following are the most frequent indicators that a person is conscious or shows signs of life:
- Moving on purpose – if a person starts moving their limbs, head, or face, you should immediately stop performing the procedure.
- Making sounds – if the unconscious person starts making sounds, it means they’re conscious again, and you should stop giving CPR.
- Eye movements – If an unconscious and unresponsive person starts moving the eyes, blinking, or focusing their gaze on a particular object, it’s time to stop the CPR procedure.
Patients With Terminal Illness
Certain studies suggest that sometimes you must avoid performing CPR on terminally ill patients. This is common for cancer patients who are usually hospitalized in the oncology or hematology wards. Moreover, the study asserts that CPR can also be futile when a patient suffers from different tumors.
However, you should remember that you also can’t always avoid CPR on terminally ill persons. CPR can sometimes save these people’s lives. But first, you’ll have to know a few important pieces of information: the severity of the illness, type and number of illnesses, functional dependence, and the different types of CPR procedures.
In cases like this, the role of trained and qualified responders is crucial. That’s why each hospital must have certified doctors, nurses, or clinics who can employ an adequate CPR procedure for terminally ill patients.
You Start Feeling Physical Fatigue
Physical fatigue is another reason to avoid or stop performing CPR. It’s known that when a person suffers a cardiac arrest or becomes unconscious after choking, we should immediately start doing a combination of chest compressions and rescue breaths.
Nonetheless, CPR can be quite exhausting and tiring. Persons who are unconscious or unresponsive often don’t show signs of life after the first few resuscitation cycles.
Some studies assert that you should perform CPR for more than 30 minutes. Nonetheless, if you’re a bystander and perform CPR on your own, you can continue until you start feeling fatigued and begin losing consciousness. Once you start noticing the signs of fatigue and losing consciousness, you should stop performing the procedure.
When 991 Arrives
According to the latest AHA guidelines, you should “phone first” before giving chest compressions. By doing so, you are making sure the paramedics arrive on time while you maintain the person’s blood flow and oxygen levels.
Once the 911 services arrive, you can stop giving CPR and leave the patient in their hands. They’ll know whether to continue the CPR, use a defibrillator, or take any other necessary measures.
You can learn to recognize these situations by certifying yourself against AHA’s CPR certification criteria. Therefore, numerous nursery homes, long-term care facilities, clinics, and hospitals enroll their employees in CPR courses where they master the specific conditions and necessities of different emergencies.
Situations When you Should not perform CPR
These were only some situations when you should stop or completely avoid giving CPR to an unconscious and unresponsive person. However, there are some factors we didn’t consider above that we will now.
Below are some more examples where you shouldn’t give CPR:
- The elderly patient decided not to receive CPR if needed;
- The scene is threatening to your well-being;
- You start noticing the different stages of death.
Recent guidelines suggest that healthcare providers should consult the elderly situated in nursing homes or long-term care facilities and the terminally ill patients about the first aid procedure and outcomes. If an elderly person refuses to receive CPR, you must comply with their wishes.
However, this decision is often analyzed as an ethical question. When a person suffers a sudden cardiac arrest, it’s hard to comply with their wishes and decide not to try to save their lives. Moreover, older persons can sometimes be poorly informed about the benefits and possible outcomes of the CPR procedure.
A person might also find themselves in the need of CPR due to pollution, smoke, electrocution, disease, or any other hazardous environment. In these situations, you must precisely assess the risk to your health and conclude whether to perform or completely avoid giving CPR.
Another situation when you should avoid giving CPR is when the person has previously suffered a chest or rib injury. Some of these injuries can be life-threatening if you do continuous and heavy chest compressions. That’s why, if you’re a healthcare provider or a paramedic, it’s critical to know the person’s injury and disease background.
The worst-case scenario when you should avoid CPR is when you notice the signs of death. This usually applies when you’ve been giving CPR for more than 30 minutes and haven’t recognized any signs of life. So, if you start noticing that the person’s body is becoming cold, the limbs are stiffening, and the color of the body turns blue, you should stop performing the resuscitation. This should all help you understand when you should not perform CPR.
Wrapping Up When You Should Not Perform CPR
You should regularly perform CPR in cases of sudden cardiac arrest, but also when the victim is unconscious because:
- They have been electrocuted
- They have overdosed
- They have been in a car accident, etc.
The same guidelines and rules are adequate for each situation. However, there are some emergencies when you should stop or entirely avoid the CPR procedure.
For example, when you should not perform CPR is when you notice signs of life, start feeling physical fatigue, notice signs of death, when the person has suffered some serious injuries, etc. Nevertheless, the boundary between the two types of emergencies (when to perform and not to perform CPR) is thin.
To decide whether to give or not to give CPR, you must have a deep insight into the different situations, conditions, and ethical issues. Additionally, certification and practice are the key advantages when you find yourself in an emergency like this.