Unsuccessful CPR

[seagull20]

My DS is a beach lifeguard. Yesterday there was an emergency on the beach, they performed CPR and used the defibrillator and then assisted emergency services when they arrived. Unfortunately it wasn't successful.

He was very upset when I collected him after work. We have talked about it a lot and he seems OK, upset and shocked but understands they did best they could. His work and the emergency services have been really reassuring too. He is very upset about the person who died and their family and kept saying 'why does everyone say well done when he died.'

I've not been through anything like this and neither has DH, we both have boring office based jobs. I'm wondering how we can best support him- can this kind of experience cause PTSD or is to be expected in this kind of job? He is only 18, I don't want to keep fussing him but I want to make sure he is OK after and stays OK too. How long does it take to get back to normal after this kind of experience.

Poor guy. Can he speak to his manager as they may have a system of debriefing after an emergency.

If he's still upset after 30 days and it is still effecting him then it can be PTSD. Have a look at acute stress disorder first and after 30 days have a look online at PTSD and go from there. Let him talk if he needs to and listen to him. Resistance and nothing wrong with contacting the GP for some therapy if he doesn't get any through work

I'm sorry your son experienced this. I have experience of this and the guilt that follows. I'm a first aider at work and was first on the scene of a colleagues fatal heart attack a few years ago. Myself and after colleague who isn't first aid trained began cpr within 30 seconds of finding him, and he hadn't been alone long. Within minutes we had more back up and the defibrillator on him, but there was no fibrillation to shock, so it never shocked him, just said keep doing cpr. The ambulance came fast and took over, but we knew it was too late. We found out he'd had a massive heart attack and wouldn't have survived no matter what. Everyone was shaken, and I certainly couldn't get the thought of his face from my head for a long time.

What helped me and my colleague through it all was the feeling that a) He had people there for him, and b)he got the proper first aid, by the book, but us and the trained paramedics, and if that didn't work nothing would. We had nothing to regret in our actions, just that we miss him! We too were thanked by the family, and felt so guilty when he'd died, but they were thanking us for trying, for being there with him in the end, it was such a comfort to them to know he wasn't alone and that everyone tried to help him.

Lastly, time really does heal all wounds, and not many people can cope with doing CPR in the first place, so you son had alot to be proud of.

Does his employer offer any kind of pastoral supervision, either group or individual following fatal incidents like this? Post-incident debriefs allow individuals to process traumatic events, on an ongoing basis if needed. If required they can also signpost for more formal counselling or other psychological support. I’d be surprised if his organisation doesn’t have anything like this, as surely lifeguards do run the risk of being directly involved with a fatality. I feel for him, it’s incredibly traumatic. Tell him CPR isn’t always successful and is very inefficient (but the best we have in a first responder situation). Just because it didn’t bring the patient back doesn’t mean he did it incorrectly. It sounds like he did everything he could which is all we can do.

I've performed unsuccessful CPR too. It was awful. A decent debrief would have helped but we didn't really get one.

Then I sat with our consultant psychiatrist one day who explained why cpr is often unsuccessful and made me feel much better. Then I did my cpr training (I hadn't actually done it in that job shockingly) and it turned into part training/part debrief.

I was much more at peace with it after then.

Your DS did the best he could. And that's amazing. Well done to him. Yes, ultimately it was unsuccessful but he kept calm and did what he needed to do. That counts for a lot.

My dp supports student paramedics.
They're encouraged to keep a reflective diary and to do things that make them feel better like exercise, nice snacks, silly films etc

It is hard going and should be acknowledged as a difficult thing to get over

Also, sometimes the statistics around cpr can be helpful. You do it because it might help, but it doesn't always help and it isnt because you did anything wrong.

CPR when done effectively, only "works" 40-70% of the time. It's not like in the movies.

See what work support they have, or if he can access the debriefing NHS system of psychology support. Bless him it's a lot to handle.

Poor guy, and so young too. I feel awful for him, I think that cpr is worth a try but in many cases will not be successful

A referral through work, his manager and GP if appropriate

Also, sometimes the statistics around cpr can be helpful. You do it because it might help, but it doesn't always help and it isnt because you did anything wrong.

I think this is really important. It NORMALLY doesn't work. It is a Hail Mary at the best of times and he gave the person a chance.

As for PTSD, he may need professional help. It's treatable but not alone.

Please reassure him that he did an amazing thing and gave the person the best chance.

The statistic is that only 7% of out of hospital resuscitation attempts are successful (Nursing Notes 2020). It is much rarer than depicted in TV and this is really important to tell people when training them in First Aid.

He should definitely have a debrief from his work but if not, can he talk to you about how he felt, if he thinks he could have done anything differently?

That's so difficult. It's hard when you have tried to help someone and the outcome isn't good.

But he gave that person a chance at least a chance of survival.

Can he talk a bit more to others who have more experience with this? That's what helped me with this kind of situation.

This article explains a bit more about success rates of out of hospital CPR:

www.londonambulance.nhs.uk/2020/01/29/we-release-new-stats-on-cardiac-arrests-showing-survival-rates-outside-of-hospital-reach-all-time-high/

Poor lad! Horrible thing to have to see at work. His employer ought to be checking on him and offering access to counselling if needed. If not, do get him to go through his GP. This is a lot for a young person to deal with. All the best, and well done to him for giving this person the best chance possible.

CPR when done effectively, only "works" 40-70% of the time. It's not like in the movies

It is far far less than this. Only 7-8% of out of hospital CPR attempts are successful in terms of the person surviving to discharge from hospital. Even then, the survivor may be severely brain damaged.

The number of 'successful' CPR attempts - where the person survives and their brain is the same as before, is incredibly small. There are successes but they are few.

So I would tell your son he did do well because he put his training into action instead of standing about like a lemon (so many people can't manage this), he was being an effective life guard under extremely trying circumstances - hottest recorded day, but nobody expects him to be a miracle worker as well.

The reality is that most CPR out of hospital won't be successful but we always try because it is amazing when it is.

Oh poor boy! The first thing to tell him is that the way he feels is completely normal - of course he feels terrible, a person died. Tell him you will help him, that he should stay away from work until he feels OK.

He needs to talk to others who have been there. It is very hard to help him when you have not been there - I think he needs to speak to someone else who tried and failed to save someone.

Poor boy, what a traumatic day at work.

Assuming he's working for the RNLI, do they provide support for their staff for this type of event? My experience volunteering in a similar emergency organisation suggests they might.

Looks like there is quite a lot of support available for RNLI volunteers (i.e. lifeboats) - hopefully this is accessible to staff as well.
rnli.org/support-us/volunteer/volunteer-zone/learning-wellbeing-and-benefits/wellbeing

It isn't PTSD yet, right now it is a normal response. Do not assume he will struggle to process it - only a very weird person would not be upset the day after their first death (e.g. a paramedic's first death is a big deal).

CPR was performed on dd1 repeatedly in the hours before she died. It’s been over 3 years but I still think about how utterly traumatic it was for the people involved. Although it wasn’t successful I will forever be grateful that they gave it their all. For hours. They worked as a team and were exhausted, but they kept going until it was time to stop.

Your DS did his best to save someone, and it might help to understand that when cpr is needed, it often can’t help. This was explained to me at the time. I’m sure some counselling would also be useful. Do his work offer a debrief meeting when situations like this arise?

I think you explain that the well done is about doing the "job" which is first organising medical help then trying to keep oxygenated blood circulating to the brain until help arrives.

He has no control over if, why or how the individual died but did his best to follow his training while in public, with all the pressures that can bring.

One simple thing which will be a small comfort to the family is the knowledge that every step which could have saved their family member was followed by your son.

That is what was "well done".

There is a Facebook group called chain of survival, if he goes on there are people there who will be able to point him in the right direction. Everybody on there has given CPR, some people have received it and survived. It's a very supportive group.

I have twice had to help people who have collapsed and on both occasions I was not first on the scene - I was just the closest person who knew cpr. I grew up in Australia where we are taught medical aid due to being surrounded by water.
unfort my second attempt was unsuccessful and if I am honest it took me a lot longer than 1 month to process - it happened in our supermarket carpark and I avoided that supermarket for 6 months. I kept going over in my mind what I would have done differently.
But…I tried and what did help me is going through it and considering if it happens to me a third time what I would do. I think your son just needs to process that he did his best - whatever the unfort outcome was he and others did what they could at the time and I am sure the family will take some comfort in knowing that everyone tried to save his life.

Thank you for such useful and supportive information. We will keep talking and listening and keep an eye on how he's feeling about it. They had a debrief with the beach manager,there were 3 lifeguards on duty and 2 were involved with the CPR. I'll ask him if he thinks he needs another debrief or counselling sessions to talk things through.

I've always understood CPR is pretty much just for keeping the blood going around the body until a defibrillator can be used. The defibrillator may work but definitely not always. CPR very very rarely brings the person back round.

Your son did all he could.

It would be a lot for any person to process let alone an 18 year old. I hope he is given the chance to talk things through and come to terms with what happened.

There is some evidence that playing Tetris soon after a traumatic event can help to prevent PTSD.

www.google.com/amp/s/amp.cnn.com/cnn/2017/03/29/health/ptsd-tetris-computer-games-trnd/index.html

It certainly can't do any harm and may help.

Well done to your son for doing such an important job and doing the absolute best he could in this situation.

This is a really thoughtful and sensitive post - I hope it's helpful for the OP. As part of my work, I have looked at the evidence for what should be offered to staff following traumatic events (and there is some NICE guidance on this). People who experience traumatic events should not be offered a routine debrief (it showed no benefit and may result in worse outcomes). Watchful waiting is recommended for about four weeks. If your son is showing signs of PTSD at this point it would be worth seeking support through his GP.

I'm sorry your son experienced this. I remember many unsuccessful resuscitation attempts I have been involved with. It does make me feel sad, but I feel some kind of peace knowing that I (and everyone else involved) did the best I could.

He and his colleagues gave that person the best chance of survival. There was no more they could’ve done. We lose patients in hospitals from cardiac arrests and that’s with specialist teams and equipment. He should be very proud of what he did.