Saturday, 25 February 2012

the journey to our destination

It always saddens me that people can’t let go. People are so afraid of loss that we sometimes ignore the basic fundaments of supporting life.

We are chiefly concerned with lives and only secondarily with quality of life. We have come to accept that CPR saves lives and does no harm. Sadly this assumption is wrong. CPR may be harmful, first, to the subject, second, to relatives, third, to healthcare staff and, fourth to society.  

I think it is important the care professionals and laymen that apply CPR also learn that in some situations no action should be taken. Sadly, as a society we are afraid to discus this. The primary reason for this is we are afraid of death. We have a hard time accepting that death is part of the human condition.

In 1990, the American Heart Association developed the Chain of Survival. This protocol addresses the fact that most sudden cardiac arrest episodes occur outside of a hospital, with death occurring within minutes of onset. For the Chain to be effective, quick execution of each and every link is critical. With each minute that passes, the likelihood of survival decreases 7-10%.


Time after the onset of cardiac arrest Survival Chances
With every minute Chance are reduced by 7 – 10%
within 4 – 6 minutes Brain damage and permanent death start to occur
after 10 minutes few attempts at resuscitation succeed

It angers me that journalists and doctors interviewed about the case of our Prince Friso all focus on the slim chance of recovery. No one seems to want to discuss the fact that the EMS personnel didn’t take responsibility and stop CPR after 10 minutes. No one discusses that we should have let go and accept that this skiing accident should have led to death.

Because of my research I know how family members will suffer the coming months / years. Even if he comes out of coma he will never be the person he was. I wonder how many people really know how bad this situation can be, when a severely brain-damaged person recovers. 

I hope and pray that we can learn to accept the loss of a loved one. This is part of life.

I’m hoping to start a national discussion that when you don’t know how long someone has been oxygen deprived you don’t start CPR. I also hope you will think for a minute in which situations you don’t want to be resuscitated and allow for a natural death. Voice your choice.  

I’m sorry if I’ve hurt people by expressing my view, but I just had to write this down. 


Rennie said...

Oh Helen wat ben ik het volkomen met je eens! Afgezien van het medische aspect ligt hier een berg aan fylosie achter hoe je kunt denken over het ingrijpen.

Judith said...

Ik ben het met je eens, het was vele malen humaner geweest om hem te laten sterven. Overigens vraag ik mij af of Piet Puk zolang rereanimeerd was. Soms is het dus helemaal niet handig om een prins te zijn! Jan met de pet had lekker mogen sterven op die berg! Inderdaad die arme Mabel, rouwen terwijl je man nog ergens 'leeft'. Hoe moet die arme meid verder met haar leven en dat van de kinderen. Nee geen situatie om te benijden!

karenfae said...

I have heard of the skiing accident of your prince and understand what you are talking about. Yes there must be a time when you know to stop the CPR or not begin it in the first place. Your prince will most likely never be the same and will need someone to take care of his every need - so sad.

Greta said...

Whether or not to administer CPR has to be a choice at the time it is needed. I am sad for the Prince's situation, but the brain is a very strange thing. Our daughter was born with 80% of her left-brain damaged by stroke; the predictions for what she would do were dim at best. Yet 31 years later in spite of multiple challenges both physical and mental she is here with us, living, laughing and loving as she can be. I am not saying it has been easy, or ever will be for her or us. But even the best doctors can be wrong so I guess it may best to do what is thought to be correct for each situation. :-)

Elaine said...

I have been at the bedside of too many cardiac arrests where the Physician wants to be the hero and continues CPR past good judgement. This is an ethical question that will be discussed by health officials for a very long time. I really appreciate your openness to discuss this sensitive topic.

Beverley said...

I agree with you. I am a nurse too in ICU. Too many heros with no common sense.