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Calif. woman dies after nurse refuses to perform CPR

Taylor said:
What's the mortality rate for someone who isn't breathing and has no pulse?
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Well, since she didn't die until much later, the obvious answer doesn't apply here. The EMTs were obviously able to resuscitate her.

But that highlights another piece of missing info - did the EMTs administer CPR?
 
Jerry said:
This woman was breathing and no one ever checked her pulse.
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If you are breathing you have a pulse. If you have a pulse, you are not necessarily breathing.
 
Jerry said:
And therefore you would not perform CPR.
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You never know--I am unpredictable that way.....I might just hit you with the defibrillator just for the fun of it too.
 
Jerry said:
This woman was breathing and no one ever checked her pulse.
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Breathing? Not really... 5-6 minutes into the call the nurse says that the woman has taken three breaths. That's 2.5 minutes between breaths. If you think that qualifies as breathing, have someone sit on your chest, take a breath, wait for 2.5 minutes, then (if by some miracle you're still conscious) take another breath, then wait another 2.5 minutes.

Besides, if you've been trained in CPR and are waiting 2.5 minutes at a time to see if someone might take a shallow breath before you go to work, you're simply doing it wrong.
 
The compressions are more important than the breathing component of CPR these days for those who learned CPR back in the Pre-Xbox Era of Civilization. THe protocols have been changed. There is also some indication that performing the Heimlich on a drowned person before starting CPR helps too.
 
Taylor said:
Breathing? Not really...
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You don't perform CPR on someone who's breathing, even just a little. You give them oxygen. You sure as hell don't perform chest compressions on someone with a pulse.
 
clownboy said:
Well, since she didn't die until much later, the obvious answer doesn't apply here. The EMTs were obviously able to resuscitate her.

But that highlights another piece of missing info - did the EMTs administer CPR?
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Not missing. The fire department arrived and having verified no DNR, immediately began CPR.
 
Jerry said:
You don't perform CPR on someone who's breathing, even just a little.
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Again, if you're waiting 2.5 minutes to see if someone might take a breath, you're doing it wrong.
 
Taylor said:
Again, if you're waiting 2.5 minutes to see if someone might take a breath, you're doing it wrong.
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Didn't you listen to the call? She didn't have to wait 2.5 minutes.
 
Jerry said:
Didn't you listen to the call? She didn't have to wait 2.5 minutes.
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Yes I did - she waited 7 minutes and didn't much care what state the woman was in. Her only concern was whether or not the correct policy was being followed.
 
Taylor said:
Not missing. The fire department arrived and having verified no DNR, immediately began CPR.
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I'm not seeing that info in any of the reporting.
 
Well, maybe it's just me, but when I'm 86, and a similar event happens to me, I want that nurse to be there, and I want her to do the same thing- well except for the calling 911 part. I don't want to have my chest pounded on, and I don't want to live on a ventilator with brain damage until someone who loves me has the sense to let me go.
 
Reading the articles posted to the news services yields a couple more gems that make this story more of a debate.

The daughter who herself is an RN has openly stated she doesn't think CPR would have done one bit of good in this case and that she is okay with the handling of her mother's case.

Also, this was NOT a nursing home (which is staffed with medical personnel and required by the state to provide CPR services), but an assisted living center (NOT staffed by medical personnel and NOT required by the state to provide CPR services).

Even more, the police and the reporters are not even sure the caller is in fact a nurse or medical personnel of any kind.

And finally, the police are saying they are investigating and thus far have found nothing illegal in what happened. However, several commenters on these articles have noted it IS illegal for the 911 operators to dispense medical advice, and yet they get away with counselling CPR on a daily basis.
 
And finally, the police are saying they are investigating and thus far have found nothing illegal in what happened. However, several commenters on these articles have noted it IS illegal for the 911 operators to dispense medical advice
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It's not illegal for dispatchers to provide such advice, at least not in California.
 
Actually (I realize that it's different everywhere you go), where I work we have EMDs. Emergency Medical Dispatchers. They do give CPR and miscellaneous other medical direction over the phone. They are licensed EMTs and sometimes Paramedics doing the job. They use cards with the instructions they read to the caller. These instructions are under the supervision of the physician or "Medical Director" which oversees their operations. When you have a calm 911 caller who is willing and able to follow the instructions given, the outcome is generally good considering otherwise.
With that said, I have been on my share of calls where I am advised over the radio that nobody is willing to do CPR. It is a moral obligation unless they are under the duty to act. Regardless, I simply walk in to the patient and go to work.
 
JMarttn said:
Actually (I realize that it's different everywhere you go), where I work we have EMDs. Emergency Medical Dispatchers. They do give CPR and miscellaneous other medical direction over the phone. They are licensed EMTs and sometimes Paramedics doing the job. They use cards with the instructions they read to the caller. These instructions are under the supervision of the physician or "Medical Director" which oversees their operations. When you have a calm 911 caller who is willing and able to follow the instructions given, the outcome is generally good considering otherwise.
With that said, I have been on my share of calls where I am advised over the radio that nobody is willing to do CPR. It is a moral obligation unless they are under the duty to act. Regardless, I simply walk in to the patient and go to work.
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Agreed where in your case these are EMTs answering the phone. However, as you noted, that's not the case everywhere.

What are your thoughts on 911 personnel offerring to take legal culpability for the county? Because that's what this one did. She advised the caller that the county would take any legal heat.
 
clownboy said:
Agreed where in your case these are EMTs answering the phone. However, as you noted, that's not the case everywhere.

What are your thoughts on 911 personnel offerring to take legal culpability for the county? Because that's what this one did. She advised the caller that the county would take any legal heat.
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The 911 operator must have something in writing there, "in the books" to be able to make that claim. As far as the jurisdiction taking the legal culpability, if it works for them, then they should roll with it. I'm mainly concerned with things on "the street level"...When you get too deep into the legal aspect, that's where you lose me :)
 
clownboy said:
Agreed where in your case these are EMTs answering the phone. However, as you noted, that's not the case everywhere.

What are your thoughts on 911 personnel offerring to take legal culpability for the county? Because that's what this one did. She advised the caller that the county would take any legal heat.
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Just sayin' here, isn't that the problem today? Everyone is so damned worried what the lawyers are going to do with a situation these days that should you get into trouble, real life or death trouble, in many cases it is safer to just let you die? Man, if that is where we are as a society, that's messed up.
 
j-mac said:
Just sayin' here, isn't that the problem today? Everyone is so damned worried what the lawyers are going to do with a situation these days that should you get into trouble, real life or death trouble, in many cases it is safer to just let you die? Man, if that is where we are as a society, that's messed up.
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In most (not all) situations, letting someone die is the most legally safe thing to do. Trying to prevent someone dying could get you fired, sued for more than you will ever have and in prison. There so exceptions for parents of minor children or whether there is a clear contractual or professional obligation.

Yes, it our society is messed up.
 
joko104 said:
In most (not all) situations, letting someone die is the most legally safe thing to do. Trying to prevent someone dying could get you fired, sued for more than you will ever have and in prison. There so exceptions for parents of minor children or whether there is a clear contractual or professional obligation.

Yes, it our society is messed up.
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And we wonder why this society is so narcissistic, so self centered. Man, I tell ya.
 
j-mac said:
Just sayin' here, isn't that the problem today? Everyone is so damned worried what the lawyers are going to do with a situation these days that should you get into trouble, real life or death trouble, in many cases it is safer to just let you die? Man, if that is where we are as a society, that's messed up.
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Yeah, I agree that is messed up. However, that's a bit outside the issue in what I was talking about (or perhaps parallel). At issue for this are two things:
1) non-medical personnel dispensing medical advice.
2) non-legal personnel assuming legal culpability for the entire county.

Neither of those should ever be the case in a 911 call. If the operator is a qualified EMT, then yes dispensing emergency medical direction is indeed in their wheelhouse. If the operator is a county attorney working as part of the county government structure, then yes, dispensing legal assurances can be warranted. I have my doubts this operator was either.

I do not want our 911 call staff to do either of these things.
 
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