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)
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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
Comment By: Mazahar Hosain
May 24th, 2010 at 11:00 pm
Mr.Roy your answer is more than expectation. Thank you.
Comment By: Unexpecting guy
June 23rd, 2010 at 2:04 am
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.
Comment By: Trish
September 10th, 2010 at 2:09 am
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.
Comment By: Lori
March 30th, 2011 at 3:12 pm
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
Comment By: Brenda M.
September 24th, 2011 at 7:05 am
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.
Comment By: Carolyn
November 6th, 2011 at 2:15 pm
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
Comment By: Jessica s
February 4th, 2012 at 12:13 am
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.