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.”

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.


Roy Shaw, ProCPR, LLC

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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32 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.

  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.


  12. I am a care worker who had to give CPR to a client last night who sadly did not survive. I have been asking the company I work for to provide me with first aid training for a while which they are yet to deliver. I have not had first aid training since I was 10 in the brownies and cannot help but think things may have been different if I knew what I was doing. I now understand that the chest compressions I did administer on the instruction of the clinicians on the end of the 999 call I made would not have been successful anyway as she was on a bed at the time, which they were aware of. Why was I not instructed to move her to the floor? Why have I not had first aid training whilst I am working in the community with clients as their care worker? Why?? I feel so guilty. Her daughter watched the whole thing. When the paramedics arrived she was not breathing but had a tiny heart beat. If I had administered it properly would she have survived? The company made me go on to finish my calls after this happened too. I feel like I failed her and her daughter.

  13. I recently lost my grandfather while performing CPR. He died memorial day 2014. I remember performing CPR screaming, begging him to breath, to stay with me. Despite my efforts I lost him. I blamed myself for along time after the incident. It hurt, it still hurts. No one should have to go through this. Afterwards my wife left me, my father blamed me along with my brother. I lost everything but through it all I have not givin in. I still have faith. I have two beautiful girls. They are every thing to me. I love them very much. I also have my dog Mocha. She’s a Chesapeake Retriever. She loves playing fetch and hunting ducks. The point is don’t blame yourself for something you cannot stop. Look at the good not the bad. God has a plan, I don’t go to church but a walk by the river or hearing a childs laughter is all a person may need. Remember the sun will rise and our ancestors, our friends, our loved ones, are looking down on us. After my grandpa died I was sitting on the porch and I felt a warm touch on my shoulder and I heard the softness of windchimes in the background. I know my grandfather is looking down on me today. Don’t lose your faith.

  14. Thank you for this explanation Roy. I did CPR on my grandfather and despite my efforts he was down too long before I got to him and although his body made it to the hospital, his mind didn’t. We had to let him go today and I’ve been beating myself up asking what I did wrong or what more could I have done to keep all of him. This really helped me see it in a different way rather than blame myself for not doing enough.

  15. My father died on May 21st. I spoke with him 15 minutes before he passed. He was on the way to the doctor. I left him alone to get dressed. I heard weird noises and ran upstairs. I just want to know if he saw me doing the CPR on him and if he could see the fear in me. I know it sounds crazy but I can’t ask him and I’m up every night thinking about this, I wonder if he knew he was dying or are heart attacks just kind of an easy way of going. I need to come to grips and find peace because each night this nightmare repeats and the images are haunting me. I’m glad I was there for him but this stings.

  16. Hello. I had to give my own father CPR two days ago, he did not make it. I turned to the Internet to try to help me cope while my mother needs me. There is such a guilt on my part. I came across this post. I know I need time to heal but thank you. I know logically that I could not have done any more but emotionally I wish I done more. This post is beautiful and just thank you.

  17. Thank you for sharing this Roy. My friend died a couple days ago from a suspected overdose. When I came on scene I provided him with cpr despite the fact that my recent EMR training told me he was already gone.

    I am still struggling with the guilt of not being able to help my friend, but your post has served as a logical reminder that all I could really do was try to help him until advanced care arrived.

    • Hi Bob,
      I’m sorry to hear about the loss of your friend. There aren’t words sufficient during these times. I’m very glad that you may have received some consolation from the episode. If you have any other questions or need further information, don’t hesitate to contact me. Peace be with you, Roy

  18. The same thing happened to me. I instructed CPR. And could not revive my mother. It has been very difficult. My heart goes out to your family member.

  19. Thank you for your article. Four days ago I did CPR on a 6 year old neighbor child who collapsed suddenly while playing outdoors. She did not survive. We did everything perfectly, but knowing that helps very little. I have tried to stay in the background, while all of us offer support to the family, but I am going through my own personal struggle. Reading your article has made me feel not so all alone – thanks.

  20. That was very emotionally helpful. My mom passed from SCA one week ago. She always said to me “once you hit a certain age you are on borrowed time”. She was a strong 92 year old woman who drove to church everyday to stores and did whatever she wanted

  21. I had to do CPR on a family friend of my my mothers he’s been in my life over 48yrs I found him slumped over the toilet and i checked his pulse couldn’t find it told my mom to call 911 I started doing CPR and kept going from mouth to mouth to compression telling my mom to tell them he’s not responding I did this over 15 to 25 minutes till the first responders came and told me to stop and they took over about 20 minutes later they came in our living room where we stood and said he wasn’t responding at all and then said the dr said to stop and said to us sorry to say but he is passed. I don’t know why but I feel like I can taste his lips on my lips even though I gargle and brushed my teeth. Is that normal. I close my eyes and still picture him and see me doing the CPR. It was hard to see my mom upset and saying the maybe if I would have check on him but I said we don’t know how long he was in the bathroom and the last time she spoke with him was around 2:30-3p. I catch myself crying and remembering him just laying dead on our kitchen floor we bleached the whole area and the bathroom down then lit a candle and said a prayer for him. My heart feels heavy and I feel drained. I went to work to try to keep my mind off of what happen it’s so hard. i never knew i would have to do CPR like that.

  22. My husband died suddenly on July 19th, at 49 years old. After his death, I learned his paternal grandfather died suddenly at 52. I am a nurse and continue to blame myself. I constantly play the game of “if onlys” and “what ifs”. He had just come back to bed from the bathroom. I asked him if he was okay, and he said he was alright. Not 5 minutes later, he jerked and started making loud breathing sounds, which was most likely agonal breathing. When I turned on the light, I saw his eyes were open and fixed to the right. He was unresponsive. I called 911. The dispatcher asked if I could get him off the bed. I told her he weighed approximately 250 lbs. Our bedroom is small. So, even if I was able to roll him off the bed, getting him in a face-up position was uncertain. So, she asked me to do chest compressions on the bed until EMS arrived, which took around 10 minutes. He was never returned to a viable rhythm. Everyone, including doctors and nurses, tells me that there was nothing that could have changed his outcome. They say he would have likely sustained severe brain damage even if he had survived. But, what would have happened if I could have gotten him to the floor… what if I had done a precordial thump… if only I had noticed the vague signs that I now remember that led up to the day of his death. I am driving myself nuts with this. I just don’t know how to put away the guilt. So many things I would love to redo.

  23. Im so glad I seen. I just lost my hubby. Im trained and cpr still didnt work. I worked on him paramedics arrived. The shocked his heart a couple of times iv meds. They worked on him for 40 mins. And he still passed. I have been feeling like I didn’t do enough. So heart broken.

  24. Nice posts here. Last May my 40 year old wife was feeling feverish, shaking, had lost a lot of weight. I went to make a sandwich, when I got to our room she was unresponsive. Called 911 and they had me pull her off the bed to the floor. The police arrived in 4.5 minutes, the ambulance 7 minutes. They had me continue chest compressions while giving her the AED. I was in shock the whole time, watching her body turn gray. They were able to revive her at the hospital, she had another heart attack and was revived again but her brain never came back so I lost her…I felt a tremendous amount of guilt because I felt like I was supposed to be her hero, but I realized that I am smaller than life itself and that’s just the way it goes sometimes. I was glad I was home that day with her. I questioned whether or not to keep getting CPR training, and I have decided I will. Just because the only time I used it and it didn’t save the one I loved the most doesn’t make it fair to whoever may need it in the future. I’m sure many of you on here have questioned that topic and I hope you do continue, and never blame yourself.

  25. On 8/9/17 After caring for my father for 10 years, that morning I walked into his room to find him out of breath. I immediately phoned for an ambulance and as I reached him, he took one last gasp and fell into my arms dead. Moments later the paramedics took over and dragged his naked body (I think he was on his way to the shower) through the house to a place where they could begin CPR. They kept at it for 30 minutes until I asked them to stop. He’d had a cardiac arrest, with an arrhythmia that is irretrievable. It was brutal and for the most part futile. There were six paramedics, and I now believe that some of them were learning, as I was later informed by a nurse that the reason they didn’t use the paddles was because there was no chance of restarting his heart. I loved him dearly, but now my mind is filled with nightmares. Please somebody tell me they will stop. Alan I hope you did get your CPR lessons, because sometimes they can be vital. Where I live in Australia there are a lot of drownings, many more would happen if not for CPR

  26. It’s 2023 and your article is still helping, your last sentences instantly made me weep, my husband collapsed on March 9 two days before his birthday he was on his first week of chemo for colon cancer but we both had high hopes of him fighting it, he went out to get the mail walked through the door and collapsed, I thought he fainted from being weak from chemo and not eating, I ran to him and his beautiful blue eyes were fixed and was making breathing noise that sounded like his snoring I didn’t understand what was going on I guess I thought a heart attack and cardiac arrest looked the same that there would be warning signs I suppose we could have been thinking the chemo was causing all the symptoms but in reality he was having a heart problem.. My husband was a big teddy bear of a man and my fear is wasn’t doing cpr correctly or hard enough even though my aderaline was pumping my arms were giving out I remember using my weight and forearm to push on his chest just to give myself a second to regain strength.. I most definitely have some sort of ptsd from this we had cpr training at work and I completely freaked out watching them work on a dummy.. Never thought I’d be a 46 year old widow.. But thank goodness so much Roy for your article and thank you to everyone else who shared their stories it helps to know others know how I feel but wish none of us had to experience it we are part of a club noone should ever have to go through..

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