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Comment by hiddenfeatures | Hacker News Reader

I don't want to be overly mean, but just look at the statistics. Those cases are far and few between. I have myself CPRed more than 50 people in my previous career. For all I know not a single one was able to walk out of the hospital - and the majority was declared dead on the scene. YMMV based mainly on country (and hence willingness / ability of the general population to deliver quality CPR)

In most cases, when the patient "survives" this means that he is disabled (can not eat, can not walk, can not stand, can not do anything)

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The point is that it is possible, not common. Which is incredible that the brain can go so long without oxygen and then fully recover, and that we may someday have the technology to revive people better or more often.

Think if you somehow had a machine that could revive and keep someone's brain alive regardless of how injured the rest of their body was. And if you had a whole hour or more to get to them. Not that it's likely to come around anytime soon, but still.

Yeah. It is basically a "think big"-story

For that we really need a mass-producible synthetic blood substitute. The holy grail is if someone suffers major damage, we put them on a continuous supply of the stuff until we can sew up all the holes, and then we get to work growing them some replacement clone organs in a lab with 3D printers.

Step 1: Determine the physiological process that causes the brain to go into a safing mode during severe/near death trauma.

Step 2: Figure out how to duplicate it with either environmental (temperature) or chemical (compound) factors.

That fact that can happen sometimes implies that it is possible to create paramedic equipment to determine the correct rate to do the CPR and apply cooling in order to get optimal results.

I would not want to be the one that has to procure the ethical clearances for the development though!

I would guess it is also a learning thing as well, given this research doctors shouldn't be so quick to declare death. Take this story where the doctor recommended life support be switched off, but she woke up three days later.

Flatliners! http://www.imdb.com/title/tt0099582/

One of my colleague's mother had cardiac arrest, received CPR right away (she was at the dinner table), and is fine now.

While this is anecdotal, it shows that perhaps the people you gave CPR to were very unlucky. Alternatively, it might be due to the delay before the CPR starts. If you're a first responder, you're probably too late unless the person had someone right next to her capable of administering CPR.

It's more that your colleague's mother was very lucky rather, than those mentioned by the GP were very unlucky.

She was lucky because there was someone who could administer CPR sitting right next to her when she went into cardiac arrest. They were unlucky because the first CPR they received was from the paramedics.

Somebody already posted this link, but didn't actually expand or summarise it, so here goes:

Radiolab did a podcast a few months ago[1] which looked at a John Hopkins survey of doctors that has been going on for decades now. 90% of all doctors surveyed said they would not want to be given CPR as a life saving intervention.

In TV and film, CPR is shown as being highly effective - well over 50%. But in reality, CPR can have a survival rate as low as 2%. The best survival rate I could find was 30%, which is where CPR is given immediately by a trained first aider. And that's the survival rate - the majority of people who survive CPR are unable to live normal lives, and may require medical care for life.

And that is not to say that people don't make complete recoveries and live long lives after CPR - it's just that the odds are overwhelmingly against them. It's telling that doctors would prefer not to receive CPR.

[1]: http://www.radiolab.org/blogs/radiolab-blog/2013/jan/15/bitt...

By the way, that 90% number means exactly nothing because it is completely dependent on the phrasing of the question. Click on your link and see that this response is conditional on irreversible brain damage. Under these conditions, the doctors also declined surgical interventions 80% of the time.

Look, CPR is a last ditch effort and there are reasons people get DNRs. But please don't go around spreading fear and confusion because of some radiolab factoid you heard.

In my humble opinion, the patient were not "unlucky" (which to me suggests that most would have faired much better on average), they were a very good representation of how the situation is/was (~10 years ago now).

In all the cases, not a single patient had been given CPR prior to our arrival. So right there, you can assume at least 5-10 minutes without any circulation. The (very rough) formula they taught us back then: every 1 minute without circulation -> 10% less chance to a successful CPR. When you go into cardiac arrest, you need CPR immediately or that's it.

In Germany the statistics at the time suggested roughly the following success rates:

  - < 3 % with no CPR prior to arrival of EMT/paramedic
  - ~ 20 % with immediate layman's CPR, fast emergency call, fast response
  - ~ 30 - 40% when EMTs where on scene during the event (immediate application of drugs, intubation, excellent ventilation, good CPR)
  - up to 70% when the patient went into cardiac arrest while in intensive care unit

Now, here's the thing: "Success" in all those cases means nothing more than 'Return Of Spontaneous Circulation' (ROSC). In layman's terms: the heart would start beating. That - of course - tells you next to nothing about brain damage.

The elephant in the room is, that when you end up being CPR'd in the street by the EMS after no circulation for 5 - 10 minutes, you better wish that you don't end up with ROSC. Because in all likelyhood you will (if you don't die after a few days in hospital / they kindly pull the plug) end with about as much brain activity as the chair you are sitting on right now.

Again: YMMV and I personally know a guy who was successfully resuscitated and became a paramedic after that. But I try to base life decisions on statistics and not anecdotes, so I personally prefer having a living will set up.

In all the cases, not a single patient had been given CPR prior to our arrival.

There's your killer factor right there... The article did talk about people receiving CPR right away from a bystander. And that was the case of my colleague's mother too - they were sitting at the dinner table together when his mom's heart went into cardiac arrest, and one of them had been trained to do CPR.

It sounds like CPR is absolutely worthwhile, based on the statistics you quoted - there's a 10x or more improvement in success rate from immediate CPR. However, that CPR needs to be immediate. The obvious conclusion is that more people should be trained in CPR techniques.

Maybe you were doing it wrong?

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