How to Deal With Death When CPR Doesn’t “Work”

This response was written after receiving an email from a person, who has a cousin that is a trained CPR provider and attempted to save their own father’s life with CPR but their father remained dead despite their efforts.  This person felt badly and didn’t know what to say to their cousin to help them not feel guilty or that their father’s death was in some way the rescuer’s fault.  I responded to them, and afterward, felt that my response may be helpful to others who have suffered or are suffering or asking themselves the question, “Was there more I could have done?”.   I hope that this response will be of help to anyone who may have feelings of failure or guilt as a result of their cpr efforts not ending in the survival of the patient.

Student’s Email Question:

(Paraphrased to protect students identity)

“My cousin has recently lost his dad and he is a trained CPR provider.  He tried CPR on him but it didn’t work. I was wondering if you had a way you deal with death if you could not save them. I just don’t know what to say to him or how to help him.  I’m the only one he is talking to and trusts. So not knowing how to help him bothers me.  If you would email me back that would be great.”
-Thanks

Dear Student,
One of the most important things to remember when providing CPR to anyone let alone a loved one, is that people who need CPR are already in a state of death.    When the person is not breathing and they don’t have a pulse strong enough to detect  with obvious signs of life, they are clinically dead.  From the point of clinical death, they are only a short distance from biological death, which is permanent.

One way of looking at the success of CPR, regardless of the outcome, helps me and I believe helps my students to be much more at peace with themselves.  The fact that your cousin’s Dad did not survive cardiac arrest has very little to do with the CPR given to him.  It’s important to remember that CPR, in and of itself does not save anyone’s life directly.  CPR is designed to “Buy Time”.  CPR only provides about 25% of the oxygen circulation that is required for someone to stay alive biologically.  CPR was never designed to be life support viewed as a way to keep people alive indefinitely, but rather to slow down the process of clinical death to biological death.  This is to provide a chance to intercept the patient with electrical therapy, advanced therapy and medications combined with CPR and time to fix the underlying problem which caused the person to die in the first place.

In my opinion what your cousin did, is give his Dad the best chance of survival possible if he was indeed going to survive.  Let’s look at clinical death as a heavy iron gate that is slowly dropping to the ground, and once closed the person is biologically or permanently dead.  CPR is like arms holding the heavy gate of possible survival open a bit longer.  Again, not stopping the progression of clinical death to biological death, but slowing it down so that if there is a chance of survival, they would have the greatest opportunity of slipping back through the gate available.  Eventually, the gate is going to close even if CPR is perfect.  As I said earlier, CPR in and of  itself is not enough to keep the human body alive.  But if the person is going to survive and the person needs more time, CPR buys the precious time required to make this a reality.

Now, it’s  important to remember a simple but powerful truth.  Everyone dies.  I have had patients that had everything go right in order for them to survive a cardiac arrest and they still remained dead despite our rescue efforts.   That day was their day to die and nothing that the cpr providers, paramedics, nurses or doctors did changed the outcome.  The CPR helped keep them viable long enough for the rescue and medical team to try and fix the underlying problem but the person remained dead.  I had to realize that as a professional rescuer and paramedic, everyone has a day to die.   It’s not my job to save everyone but it is my job to give everyone the best chance of  survival possible.  When I provided care to cardiac arrest patients, I provided care to them as if they were suppose to survive and didn’t give up hope unless they proved to me otherwise by not surviving.  It may be frustrating but we  just cannot know what day is the day a person is going to live or die until the outcome is evident.

I’m quite sure that no matter what I say, your cousin is really missing his Dad.  I don’t think there is any amount of explanation of science, death, dying and CPR that’s going to change that.   One thing I do know about what your cousin did the day he provided CPR for his Dad though, he showed others and his Dad how much he loved him.  How much he really cared.  Your cousin gave his Dad his own strength when his Dad didn’t have any of his own.  In my opionion, that’s one of the most loving and unselfish ways to tell a daddy goodbye.

May God bless your cousin and all hurting friends and family during these difficult times.

Sincerely,

Roy Shaw, ProCPR, LLC
RoyOnRescue.com

Roy Shaw

Roy Shaw

Roy is the lead trainer and co-founder of ProTrainings. He is also an EMT paramedic whose opinions about rescue come from many years of experience on the ambulance.

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14 comments on “How to Deal With Death When CPR Doesn’t “Work”

    • I also tried CPR on my 38 year old brother who didnt survive. I didnt give up until the medics arrived. You see, my brother had his wife inject heroin into his vein. I have just beat myself up over and over! But in the end, it must have been his time to go. Yes I was trained in CPR in nursing school. He passed 12/16/2013.To this day I am grieving…waiting for time to heal wounds. br.lenning@hotmail.com

  1. I randomly came across someone having a heart attack. I had to rely on CPR training I hadn’t remembered in a decade. The person died.

    Thank you for writing and sharing this. It helps me assuage my feelings of guilt/inadequacy that I wasn’t able to affect the outcome.

  2. Thank you. I recently had to give CPR to a very close friend and he didn’t survive. There seems to be little support out there for us ‘laymen’ who find ourselves in this situation. I knew what to do, I performed CPR to the best of my ability (albiet with a damaged wrist 2 weeks out of plaster) – the grief and the ‘if I had done’ etc remain. I kept on until the ambulance arrived (nearly half an hour) I was at the point of thinking I would go into cardiac arrest myself. I know the grief will work itself out and that I have nothing to feel guilty about, but it is an experience that I don’t think anyone who hasn’t been through can really understand. It is very personal and difficult to deal with. Again, thanks – your voice here is a blessing.

  3. Thank you for this web site….I am a Professional Ski Patroller and an EMT. Very recently I went on a call on our mountain , the adult male struck a tree with a great deal of volocity , when I arrived he was unresponsive, no pulse or resp’s …I called my dispatcher and declared a “code” and began CPR. The scene was difficult with a lot of bio….This was my first code and while I think I am handling it well , I’m not sure how I am supposed to handle this ….My co workers and supervisors have been very supportive and caring. I have been having a few flashbacks and I still think about the scene everyday, going over and over my procedures and although I now I did everything possible I still continue to review ….Is this normal ?

    Thank you

  4. I was searching the web for some comfort after administering CPR for the first time and to an acquaintance that did not make it, in front of some 20+ withnesses and friends. Two days later I have still not gotten back to normal. This has helped, thank you for writing this Roy Shaw.

  5. That happened to me this morning. I found my father on the floor and I can’t stop crying bc I feel that I couldn’t save him. I’m a nurse, so I know we can’t save everyone. But it’s just not suppose to happen this way. Your last paragraph where you said that what I did was the most loving and unselfish thing i could do when he couldnt do it for himself.. i will hold on to that forever. Thank you for your kind words

  6. Today I came upon a truck in the ditch and two men giving cpr to another gentleman. I decided to see if they needed help. As soon as I offered, the men stopped and asked me to continue, which I did. I did cpr for about 15 minutes, until the abulance got there and had him loaded. As I left the scene I was hoping that I would be later shaking that mans hand, but I just found out he died. I cant sleep, cant get his face out of my head. Thank you for the article and other peoples stories. It has helped.

  7. Thank you Roy, I’m still dealing with these types of feelings. Very nice to hear the …Your last paragraph where you said that what I did was the most loving and unselfish thing i could do when he couldnt do it for himself.. i will hold on to that forever. Thank you for your kind words agree with Carolyn of Nov 2011, why doesn’t anyone say that? It is healing, thanks! Definitely true, appreciated Roy.

  8. My dad had heart disease, I has seen him unwell many times and I his heart had lost strength, but to me he seemed invincible. My dad collapsed in the front passenger seat of my car as I was driving him to the hospital (after he convinced me that he didn’t need an ambulance) & my mum was sitting in the back seat. I screamed as he slumped & fell on me as we turned the corner. The hospital was only a 5 minute drive from home but I told mum to call an ambulance. They told us to stop driving & check to see if he was breathing. My mum panicked and stood on the curb whaling & I took over the phone.

    I couldn’t tell if he was breathing, his jaw was clenched tight, his tongue was caught between his teeth, I pulled it open. There’s warmth I told the lady on the phone, but I don’t know if he’s breathing. She said to lay him flat. My dad was a over 80kgs, there was no way I could get him out of the car to lay him down. So I flicked the seat down & watched his lifeless body bounce, his eyes were open. She counted the beat while I did chest compressions from the back passenger side door. I had done CPR training & knew I had to push hard. I used all my weight when I pushed down & could feel his body move awkwardly beneath my hands.

    The ambulance arrived about 10mins after i had stopped the car. I then watched as they dragged him from the car. They worked on him while we watched & eventually told us that even if they were to keep trying, he would be brain dead. They pronounced him on the side of the road shortly after midnight.

    I have struggled with this in so many ways & yet feel comfort in being with him when he left. I have struggled to find any material that relate to my experience to. I have felt isolated in not being able to share how I lost my dad, This story & the words you have written have helped me process & understand my own experience. Thank you.

  9. My mom was sick with cancer and that last day when she fell into a coma, I knew something bad was about to happen. When she stopped breathing, I started to perform CPR and I screamed for the doctors and nurses to help but no one was willing to even come in the room. I performed CPR for about 30 minutes. She never came back. I felt so guilty for letting her go. The worst part is that I promised her that I will save her.Christmas is in 2 days, what if I could have saved her, she’ll be home now getting ready to celebrate. I only had to save one person, the person I loved the most but I failed!

  10. I too struggle with a failed attempt at saving a man’s life. My husband’s employees, one older and one younger, were at my house helping me with some computer work. The older man, 55, gently slumped over. I looked up and asked what’s wrong and was told he had narcolepsy. Since, they know each other well and I don’t, it sounded like a plausible reason. I asked if this had ever happened before and was told no. Then, he suggested that it was diabetes, which he has. I asked again if this had happened before and was told no. Instantly, I ordered him to be placed on the floor while I grabbed the phone to call 911 and instructed him to position the victim for CPR. Though I now CPR, I decided to have the operator instruct the coworker how to perform it because I have a shoulder injury and due to the victim’s hefty size, I felt could not press hard enough. Also, I have three dogs that I had to quickly isolate, open the front door, and move furniture so the paramedics could work. Luckily, within just minutes the paramedics were here. After 45 minutes they finally got heartbeat, but after a week on life support, he died.

    I struggle that I didn’t react sooner because precious seconds ticked while his coworker felt he knew what was wrong. I was astounded when the following day, he told me that none of the victim’s male family members lived past 50 because of heart disease. I don’t understand why that wasn’t the first thing he said. Maybe he too was in shock and was grappling with the unfolding crisis. I’m also struggling with the decision not to perform CPR myself instead of having his coworker do it.

    Despite the slight delay, a lot of things went right that day. If the day had gone as planned, he would have been on a roof or on a freeway. It was only because the customer opted not to have some work done that he was at my house. It was truly a blessing that he wasn’t on a freeway.

    Sadly, he leaves behind two teenage children and a disabled brother whom he was their sole support.

    In the end, I think he had a catastrophic event that was not survivable.

  11. Last Tuesday I gave CPR to my close friends 6month old baby angel. Your article has helped me come to grips somewhat with the fact I gave his family 2 and a half days to say goodbye. I couldn’t save him. It was his time to go. But I need to know how do I get the image out of my head. His mothers screams and taking him from her he was all limp and the CPR itself believing I could see him responding. I loved him like my own and don’t know what to do. But I thank you for making me understand that little bit more.

    • Hello Lilli,
      I am so sorry to hear of this terrible event that has occurred. I do want to encourage you once again, that you did the very best thing that anyone could ever do in such a situation. You provided compassionate care to the baby and by the sounds of it, as a result, the parents had a bit more time to say goodby than they would have if nothing would have been done. It is very normal for you to experience visual, auditory and even tactile memories of this experience. I believe it’s a way for us to work through the grief and to learn from it for the future, meditate on the mystery of what has occurred and cherish every moment we have with those who are present with us right now. My hope is that as you recall the memories of what occurred and you see, hear, smell or feel the memories of your dear friends faces, screams and the look and feel of the baby, it will only reinforce that you were a true and most loving friend. Sharing your selfless compassion with your dear friends and working along side them to love, care and try to rescue their dear baby. Be at peace during this time and I hope that you will draw strength from knowing that you did the best thing that could have been done. You did not fail in any way, but you succeeded in showing ultimate compassion to your friends and the dear baby.
      Peace be with you.

      Roy

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