Podcast: Play in new window | Download

Subscribe: Apple Podcasts | RSS

If you want to know if CPR (cardiopulmonary resuscitation) is always the best option for cardiac arrest or if a DNR (Do Not Resuscitate) or NFR (Not for Resuscitation) is the better option, stay tuned! I’ve got news for you.

My name is Patrik Hutzel from intensivecarehotline.com, and I have another quick tip for you for families in intensive care today.

So, one of the regular questions we get quite frequently is, “Is CPR, which stands for cardiopulmonary resuscitation, always the best option for cardiac arrest or is a DNR/NFR the better option?” DNR stands for, do not resuscitate, and NFR stands for not for resuscitation.

This is obviously a topic that is always or can be an issue in intensive care units, in ICUs, critical care, but also in other areas within a hospital. But obviously, my background is critical care nursing, so I see it from that angle mainly, and because I talk to families in intensive care and Intensive Care at Home almost daily, I have an appreciation for the whole topic, and sometimes it can be a very controversial topic.

Let’s break this down so that you can understand what’s the best option here if there’s a cardiac arrest. Is CPR always the best option or should people not be resuscitated? In cases of a cardiac arrest, whether CPR (cardiopulmonary resuscitation), or DNR (do not resuscitate)/NFR (not for resuscitation) is the better option depends very much on the individual’s medical condition, their wishes, and the context of their health situation.

So, CPR is typically recommended if the individual has a chance of recovery or survival, and there are no prior wishes indicating otherwise. It can be lifesaving in certain situations, such as when a person is young, healthy, and their cardiac arrest is due to reversible causes, i.e. heart attack, drowning, trauma, etc.

Number 2, DNR or NFR. Again, DNR stands for do not resuscitate or NFR stands for not for resuscitation, orders are applied. When the person has a terminal illness, or a very poor prognosis has expressed a wish not to undergo aggressive life-saving measures in case of cardiac arrest, this decision is often made after careful consideration by the individual, their family, and healthcare providers. It may be preferable if the individual is facing a poor quality of life, or if resuscitation would not improve their overall prognosis.

Ultimately, the best option is based on the individual’s values, their health condition, and what they have expressed or documented about their treatment preferences. For someone with a DNR/NFR order in place, CPR would not be administered as the focus is on providing comfort rather than prolonging life through invasive interventions. In any emergency, medical professionals will assess the situation, consider any known directive, such as a DNR, and make decisions based on the best interests of the person involved.

I will say this, I would have made other videos here where I’ve said do not agree to a DNR, and I still stand by that, or do not agree to an NFR and I still stand by that. Unless, with the exception that your loved one has an advance care directive where they say, “I don’t want to be resuscitated in case of a cardiac arrest.” If that’s what they’re saying, then you should absolutely go with that.

But if it’s something that’s potentially being pushed onto you by intensive care teams saying that your loved one should have a DNR or an NFR because if they do survive, they won’t have any quality of life or they won’t have any “meaningful” quality of life. But it’s not up for intensive care teams to decide, that it is up for the patient or for the family to decide, because what’s meaningful for the intensive care team might not be meaningful for you and vice versa. So, don’t let other people lecture you or educate you on value judgments, because the value judgments are up to you and your family.

Now, that another thing that you hear over and over again. When it comes to discussions around CPR (cardiopulmonary resuscitation) is, “Oh yeah, all people do is doing CPR and then patients end up with cracked ribs.” That is a reality, I’m not disputing that here for a moment that CPR can fracture ribs. But the question is to what end? If someone’s life is being saved by cracking a few ribs, then again, it’s up to the individual to make that call, whether they want that or they don’t. It just needs to be documented and it’s not up to intensive care teams to make that decision. Because at the end of the day, whether that’s doctors, nurses, we all went into this profession to help people, and I strongly disagree with prematurely ending the life for patients in intensive care. If there is hope and there’s an outlook of life, and that’s what people want, it all comes down to what people want.

Once again, from my perspective, it is not up to intensive care teams to make value judgments about quality of life and whether people should have CPR or not. It is up to the patient and the family to make that decision.

I can also tell you, I have worked in critical care nursing for 25 years in three different countries where I worked as a nurse manager for over 5 years. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives for our clients and families in intensive care.

You can verify that on our intensivecarehotline.com podcast section, we’ve done some client interviews there. You can also verify it on our intensivecarehotline.com testimonial section where you can read what our clients say about the services they receive. Like I said, we have saved many lives for our clients in intensive care with our consulting and advocacy. Once again, you can verify that on our website at intensivecarehotline.com.

One thing that I’ve learned over the years after working in critical care for so long is that DNR orders or NFR orders in ICUs are never a good thing, because it’s the first step of a treatment removal. It’s just the perception of if someone has a DNR or an NFR that they are going to die anyway and that’s why we shouldn’t resuscitate them. It’s just a perception in ICU and it’s not a good perception. It’s almost the first step towards a withdrawal of treatment, and that is one of my main concerns here.

One of the main reasons why I advocate for never agreeing to a DNR, unless you are very clear about that is what you want as a patient, or that is what your loved one wants as a family, and your loved one is not in a position to make that decision, and you are the decision maker. That’s the only time when I would say a DNR has its time and its place. DNRs have their time and their place, but most of the time, from my experience and also from my professional opinion, they don’t have a time and a place.

We have helped hundreds and hundreds of members and clients over the years to improve their lives instantly when they have a loved one critically ill in intensive care. Like I said, we have saved many lives with our consulting and advocacy.

That’s why I also do one-on-one consulting and advocacy over the phone, Skype, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply can’t afford to get wrong. I also talk to doctors and nurses directly. When I talk to doctors and nurses directly with you or on your behalf, I ask all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care.

We also do medical record reviews in real time. We also do medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

I also represent you in family meetings with intensive care teams.

We also have a membership for families of critically ill patients in intensive care. You can become a member if you go to intensivecarehotline.com, if you click on the membership link or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related. You also have access to 21 eBooks and 21 videos that I’ve personally written and recorded that will help you to make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets the best care and treatment always.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, comment below what you want to see next, what questions and insights you have, and share this video with your friends and families.

I also do a weekly YouTube live where I answer your questions live on a show, and you will get notification for the YouTube live if you are a subscriber to my intensivecarehotline.com email newsletter and a subscriber to my YouTube channel.

Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com, and I will talk to you in a few days.

Take care for now.

Related Articles:

Quick Tip for Families in Intensive Care: Another Inspirational ICU Patient Survivor Story of a Patient Who Was Once Declared “Brain Dead”! Quick Tip for Families in Intensive Care: ICU is Pressuring Me to Send Dad to LTAC (Long Term Acute Care) After Only 6 Days of Intubation, This is Wrong, Help! Quick Tip for Families in Intensive Care: My Grandfather has Septicemia in ICU Ventilated & in an Induced Coma. What are His chances for Survival? Quick Tip for Families in Intensive Care: How to be More Assertive When You Have a Loved One Critically Ill in Intensive Care! Quick Tip for Families in Intensive Care: Dad’s in ICU on a Ventilator with Pneumonia, He’s Following Commands! ICU Says He Needs a Tracheostomy