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.

@Eek3under3 so sorry about your Dd xx

I always justify it that the person who has had a cardiac arrest is dead. Dead if you do nothing so any CPR is only an attempt to get them into a state that is ready for medical staff to try to bring them back to life.

it’s really hard mentally and statistically it’s likely to fail. You have to detach from the emotion and look at the statistics.

unfortunately I don’t think your son has been prepared well. Often the physical aspect of performing CPR is taught without the emotional part. Please seek some help for him if he is still this way soon.

Poor poor boy. I’m a nurse and did CPR for the first time when I was a student nurse aged 19, unfortunately she never made it either. The situation was sudden and traumatic and I probably thought of it daily for the following 4-5 months. What helped me was talking about it and gaining a further understanding of the resus process, there’s a lot of available information on the British resus website.

He should be able to contact the beach manager or ambulance service for another debrief and I really would recommend him going to speak to someone else about it as it can lay so heavy on your heart. However at the end of the day CPR can only reverse reversible causes of death and is not at all how it’s depicted in media. It’s also a very hard thing for experienced professionals to do nevermind a teenager. It sounds like he had done amazing and should be proud of himself however it’s going to take a while for him to process that unfortunately.

It's an awful thing and I've watched my highly trained nurse Mum carry it out on a crowded boat and it was very sadly unsuccessful. The gentlemen in question had an unsurvivable heart attack and could not have been saved. I would be saying to your son you tried you didn't freeze and that's more than a lot of people can manage. You've got a good one there OP.

I'm a first aider at work, and St John Ambulance has a number you can call if you've been involved in an incident like thus. Don't know if the RLSS has something similar (it's somehow 30 years since I was a lifeguard, and things have changed since.)

It's an entirely normal reaction,to think about what you could have done differently, but CPR is often unsuccessful- but he needs to underwear did everything he could everything has trained for. That doesn't make it easy though - and it shouldn't - people matter, and a death is important, even with doing everything right. It would be far more worrying if he got over it instantly. But processing it takes time, so just be there for him.

Yes medical tv shows and dramas have a lot to answer for.

cpr rarely works. Even if it does initially, i think the stats are 70% don’t survive the next 24 hours, and 70% of those don’t live a week.

it’s also a brutal process, physically exhausting for the person giving, and on the body of the recipient.

DNAR’s are not a bad thing for this reason.

I did it at a similar age with the same outcome and carried the feelings of guilt and failure for years as there was no support back then, it is only through therapy for something completely unrelated that I have found peace with it all. He should be offered further debriefs in the weeks and months to come so he can process it. He did good. Just being able to step in and do is something in itself, I hope that one day he can reconcile his feelings and recognise he did what he could.

I am a fully trained first aider for almost 30 years (and CPR trained for a few more than that from beach lifeguard training too). ALL my training has been strong on the fact that there is a less than 50% success rate with CPR normally, partly to do with technique and the fact it is very tiring, but also that the outcomes are poor for the patient in many cases if they have gone into cardiac arrest and even if in hospital with a defibrillator there is a relatively low positive outcome.

What your DS has done is to keep the blood and oxygen flowing around the body of the patient as long as possible until more trained help arrives with more equipment and better drugs to keep working on the patient. So he has given them every chance of being able to respond to that higher level of treatment when it arrives - and that is much higher as a result than if nothing had been done.

I have not personally had to do CPR on a patient - lots and lots and lots of training over the years, and I now teach it to others. But a colleague did have to do it at work, unsuccessfully (and I was the person who dealt with her in the aftermath) and that was tough on everyone.

Your DS has done something physically strenuous.
He has done something emotionally difficult in dealing with a person dying (and he may not have had that experience before either).
He may be getting praise for "having done a good job" (of doing CPR and keeping going until paramedics etc arrived) which is merited for the action but he may be feeling guilty or upset that what he did was not enough for the patient. So there can be a swirl of all perfectly valid emotions and feelings.

There is probably also an element of needing to relive it through the paperwork that is probably needed (in triplicate) for work etc, and the various people who were there debriefing and discussing once professionals left and then the others who were not there at the time coming later or today and wanting to know all about it (sometimes to know what's going on and needs some kind of action, sometimes out of concern for the people who were involved, and some just feeding the drama or looking for a story to be able to tell).

Let him get out what feelings he has, they are valid.

But also make sure he knows he did a good thing and sometimes good things are not enough for a good outcome for very many reasons.

Try not to overwhelm with questions and concerns.
But give him space to come to terms with it all, allow him to talk if he wants, and if it continues to be a burden for him, there are supports available - there should be a system in work, but he could definitely ask the local hospital or red cross or similar if there's someone he can talk to.

I remember from a first aid class that they told us that most people who need cpr dont survive. They gave us a percentage and i dont know the number i just remember that i thought ‘wow, thats not a high success rate at all’.
Maybe try to google the numbers to give him some perspective.
I could imagine that this can be a very traumatic experience. Do they have someone at his work that he can talk to?

Poor lad. Witnessing and being a part of such a tragic event at such a young age is really tough. Hopefully in time he will process it and feel better, knowing he did everything he could.

I’m a clinician and always remind trainees that when someone has a cardiac arrest they are dead - sorry to be blunt but they are. Their heart isn’t pumping in a normal efficient manner, not enough to sustain breathing or consciousness or perfusion (oxygenation of cells).

As a first responder you can’t make them any “deader” - so everything he did would have helped. CPR/BLS just buys the person time to maintain an oxygen supply to the brain and central organs until the heart can be restarted into an effective pumping rhythm. And this isn’t always possible - certain rhythms aren’t able to be defibrillated and there is virtually no chance of survival. Even with amazing CPR full recovery rates for out of hospital arrests are vanishingly small.

Give him time, and if his entirely normal feelings persist speak to a GP or someone through his life guarding.

The shock off the incident will take time to recover from, the traumatic deaths I've witnessed have stayed with me and I can still picture these patients, today.

It's good he's got you to talk too and can express his feelings.

The famiy of young man I nursed, who died unexpectedly, wrote a lovely note to me including the young man's eulogy - they expressed how good it was to know somemone was him and cared for him when he died.

I would imagine the family of the man your, son tried to save, feel the same. That someone was with him and tried to save him. The man wasn't alone when he died.

According to NICE 1 in 10 survive an out of hospital cardiac arrest and then 7-8% will be well enough to survive leaving hospital.

In the last 5 years I’ve seen about 8 cardiac arrests myself and only one of them survived the arrest, only to die less than 24 hours later.

While CPR and resus is important and can work miracles, the media does project an unrealistic expectation of it’s success.

People say well done because they can see everything possible was done and take comfort from that , and sometimes despite the odds someone's life will be saved . If it was one of my relatives I would be grateful they tried .

Your son gave the patient the very best chance before the ambulance crew got there. But CPR primarily just circulates oxygen around the body it doesn't necessarily resolve the arrhythmia that's stopping the heart beating effectively, that's why a defib is used to shock the heart back into an effective rhythm. CPR on it's own hopefully keeps oxygen going to the brain and vital organs until more advanced treatment can be tried.

Potentially it's worth considering that with something like a heart attack pre-arrest, the cause (blockage) will still be there and whatever you do, it's the blockage that's the problem. If the heart muscle is too badly damaged no amount of CPR is going to fix it.

Definitely suggest your son seeks more support via his lifeguard organisation. I'd be surprised if they don't have anything. Ambulance services definitely do and it's really encouraged to talk about it.

I'm sorry OP. When I was 18 I performed unsuccessful CPR on someone who had died in pretty awful circumstances too, it took a few months to start feeling a bit better and I felt I could put it behind me a lot more after I gave evidence ay the coroners court. I hope he's okay

My Dad collapsed in the street. Massive heart attack. 2 off duty police officers passed by, saw him and stopped to give him CPR. A passing ambulance stopped with a defibrillator. They worked on him until the ambulance arrived. Unfortunately my Dad didn’t survive but I can’t tell you how much it helps knowing he was given every chance possible. Without the CPR I’d always have thought he may have survived if only there had been someone with him. 5 years on I’d still be tormented. I went to the police station to thank the police officers who gave my Dad CPR. I know how devastated they were that he didn’t survive but I just wanted them to know how grateful I was for all they did for him and also that I was glad he had people with him when he died. Tell your son he did everything he could to give that person the chance to recover and he should be extremely proud of himself. Sometimes it just doesn’t work and it’s nothing to do with skill or ability. One day, he may be required to do exactly the same and it’ll have an entirely different outcome.

I'd say contact his work in the first instance. Ideally they'd provide some support. I work in HR and have had occasions where staff have been on the scene of a death, we contact our Occ Health and Employee Assistance Programme to put together a support package including counselling.

CPR is not as successful as depicted in the movies. I've heard figures of 25% and less in the past when not in a hospital setting. What important is to try, because sometimes you save their life. I've personally not ever had to despite being trained as a local first responder - I'm sure I will be upset too in his position, but the family will be grateful they tried

It’s traumatic to do and witness and devastating when everyone involved has given all they can and it isn’t successful. I think tv/films romanticise it. It’s brutal and isn’t as successful as u think. Despite it being unsuccessful this persons family will know every effort was made and will be so thankful for your son. It’s absolutely shit. It may be helpful for ur son to chat thru what happened with others who were involved or to anyone really.

Can he contact the ambulance service and ask if one of the paramedics would be able to go through things with him? I’m a GP now but when we are we’re involved in horrible events in the hospital we would always have a team debrief. It was always very cathartic and gave the opportunity to ask those lingering questions that had been running through your mind and the “what ifs”.
It sounds very traumatic for him and I’m sorry to hear he had to go through that.

Same happened to my dd a couple of years ago when she was 18. She knew she had done everything possible but it was still difficult. I had a chat with her boss who had told dd to tell me to contact him if I wanted to and we discussed support. He debriefed the two lifeguards and reassured them they did everything they could have done. They were also provided with counselling by work.

If there has been no mention of counselling, I either get ds to ask about it or contact the employer myself. I know technically they are adults but they're still kids and it's a lot to deal with so I wouldn't be concerned about interfering. Also, if they haven't been debriefed, I would ask for that too.

The other thing that helped dd was chatting to the other lifeguard who was involved (they are good friends anyway) and to her brother who is also a lifeguard. The main thing is to get him talking, let him express how he feels and, while it is ok to say they did everything possible, don't dismiss any feeling of guilt he may have about not saving the person.

Dd was also expected to go to the inquest. Her boss accompanied the 2 of them. She actually found that very helpful as when the details were read out, she could see that there was nothing more they could have done. They did everything by the book.

The family made a point of thanking them for their efforts, which was also helpful. However, the person who died had had a heart attack so it wasn't a drowning as such.

Poor boy. What a brave thing he did.

You’ve had excellent advice on this thread. It might help to reassure him that his feelings are normal. And also to help him separate his efforts from the outcome. CPR is rarely successful but it’s the best remedy we currently have.

As the lifeguard he did his duty to promptly perform CPR. He discharged his responsibilities conscientiously. He fulfilled his role and did his best for the man. His conscience can be clear. But he’s not responsible for the outcome, as he’s not God. The outcome was always out of his hands. As it is for everyone else.

Sending you both the best or wishes.

I’m non medical but had had CPR training and successfully resuscitated a family member - at the time I knew the chances of success were very slim and even though the end result saved their life I still think about it 10 years on.

There is a Facebook group which I wish I’d heard about earlier - I think a PP referred to it. Carrying out CPR - whether or not it’s successful - is impactful. As PP said it’s not PTSD yet but a very normal reaction to an intensely stressful event.

Well done to your DS, I mean that sincerely.

PTSD is way more likely if you start thinking he's likely to have it. Constantly going over what happened and worrying will give a poorer outcome. Better to discuss it briefly and get on with life.

If deaths caused PTSD every single healthcare worker would be unable to work. Mostly people get over it. Even if they're seeing a few deaths a week.

Had similar advice from The Red Cross to call them if you ever needed someone to talk to after performing CPR (even if successful) as it takes a lot out of you physically and mentally. They also said we could call the Samaritans if necessary, just to talk to a trained person. He did a very brave thing, yet there are many that cannot be saved. He gave the best chance the person could get.