Medical Resuscitation: the unnecessary distress due to misconception

CPR or cardiopulmonary resuscitation is a medical procedure that is often misunderstood. It causes lot of anguish and distress to patients and family unnecessarily.

It is sometimes colloquially known as “kiss of life” as “mouth to mouth resuscitation” was previously used in pre-COVID era along with “chest compressions”.

CPR may involve “electric shocks to heart” when needed if machines are available. CPR in hospital may involve “tubes pushed down the throat” to enable air get into lungs. CPR almost always involves someone “pressing hard on the chest repeatedly with both hands” so as to help air get into lungs.

Overall, it can appear a bit brutal but it can be a life saver. That’s why the work places, train stations, airports and some public parks have the automatic defibrillators.

CPR is a wonderful medical first aid, which, delivered promptly, can save lives. It is highly successful in previously fit people with a sudden cardio respiratory arrest due to a “reversible or treatable” illness.

Television serials and Hollywood movies often portray CPR as a highly successful procedure.

But, unfortunately, in routine hospital practice, the success rates are low.

In particular, success rates are very low in “terminally ill” cancer patients and in frail patients with “multiple irreversible medical conditions”.

Because many people believe CPR is hugely successful in “everyone”, patients and families understandably get very upset when the medical team talk about “do not attempt resuscitation (DNAR)“.

When CPR is NOT used appropriately, it prevents peaceful death and stops terminally ill patients from gently fading away surrounded by their loved ones.

In cancer patients, when cancer treatments are not working, death occurs after the body has been overwhelmed by cancer. Trying to re-start the heart and lungs after the organs have stopped working due to cancer is often futile. More importantly, CPR can make death more traumatic for patients and family.

Other than educating people about benefits and limitations of CPR, there is no easy way to make this misconception about resuscitation go away.

Read my BMJ letter on this topic and contribute your views on the rapid response section of BMJ.

BMJ. Misconceptions about CPR distress patients at the end of life and bereaved people.

Toll-free link:
http://bmj.com/cgi/content/full/bmj.n1060?ijkey=YhH9UQOseeXaJzT&keytype=ref

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

Are spirits and beers more risky than wine?

Yes, according to a recent UK biobank study.

A large study of 309,123 participants found that Spirit drinking was associated with higher risk of early death compared to red wine drinking.

Beer/cider drinkers were also found to be at a higher risk of early death.

Alcohol consumption without food was associated with higher risk of early death compared to consumption with food.

Binge drinking with Alcohol consumption over 1–2 times/week was more risky compared to drinking spread out over 3–4 times/week.

But the study doesn’t seem to have looked at teetotallers. The study specifically excluded Abstainers and infrequent alcohol consumers. It is quite possible that avoiding alcohol altogether may be more beneficial but that might not be acceptable to many people !

As usual most of studies relating to food and drink need to be taken with a dose of healthy scepticism.

References:

Daily Mail. I Drinking wine instead of beer or spirits is healthier and could cut risk of death, study suggests. By Xantha Leatham For The Daily Mail 01:49, 12 Jan 2021 , updated 01:59, 12 Jan 2021

Association between patterns of alcohol consumption (beverage type, frequency and consumption with food) and risk of adverse health outcomes: a prospective cohort study. Bhautesh Dinesh Jani1* , Ross McQueenie1, Barbara I. Nicholl1, Ryan Field2, Peter Hanlon1, Katie I. Gallacher1, Frances S. Mair1 and Jim Lewsey2. Jani et al. BMC Medicine (2021) 19:8 https://doi.org/10.1186/s12916-020-01878-2

BBC. No alcohol safe to drink, global study confirms. By Laurel Ives. BBC Health. Published24 August 2018

Guardian. Study finds one small alcoholic drink a day raises risk of irregular heartbeat. Researchers examined heart health and drinking habits of 108,000 people aged 24 to 97 over 14 years
The report found people who consumed equivalent to a 330ml beer, a 120ml glass of wine, or 40mls of spirits were 16% more likely than teetotallers to develop atrial fibrillation.
Ian Sample Science editor
@iansample
Wed 13 Jan 2021 06.00 GMT

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Risk of Death from COVID-19: does ethnicity matter?

Yes, people from different ethnicities are affected in different ways by Coronavirus.

People of white ethnicity seems to be at lower risk.

People of black ethnicity seem to have higher risk of severe disease but seem to survive better than South Asians in UK.

South Asians who are hospitalised in UK due to severe disease seem to have the highest risk of death.

More work needs to be done to identify underlying the biological factors responsible for the increased risk of death in South Asians in UK.

BBC News. Covid: South Asian hospital patients ‘at greater risk of dying’

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.


The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.