NPR published an article which may be of interest to you:

http://www.pbs.org/newshour/rundown/2013/03/when-cpr-for-the-elderly-becomes-morally-gray.html

The while article is probably worth reading for those of you who are really into the issue. But a few paragraphs caught my eye --

The person on the other end of the phone was a trained nurse, but her job in the facility was administrative, not nursing:



The coordinator is now on voluntary leave while the company figures out what to do.

As for the legal issue:



However, the article points out that the company could still be sued, even if the individual couldn't be.

Finally, the victim in question had a stroke, not a cardiac arrest. So the CPR might not have helped.

Huh? Are you implying this person still had a heartbeat? You don't do CPR on someone who has a beating heart. What caused a cardiac arrest - be that stroke, myocardial infarction, drugs, loss of blood volume, whatever - doesn't matter. You still do CPR. True, some causes of cardiac arrest are less survivable than other causes, but that doesn't mean you withhold CPR. For example, cardiac arrest due to trauma is only rarely surviveable, but first responders shouldn't be making a judgement call on that in the field.

From the NPR article: "The scene is now familiar to many: Lorraine Bayless, 87, was barely breathing at Glenwood Gardens independent living facility in Bakersfield, Calif." It looks like CPR would indeed have been inappropriate.

In any case, when you administer CPR, there are only seconds left in the fourth quarter, and you are throwing a hail Mary. Your victim is probably going to die, unless they are dead already. That has been my experience in the two real world situations where I have given CPR.

My CERT trainer, a highly experienced fire captain, said that of the 300 or so CPR situations in which he was involved, only seven were significant saves (the victim walked out of the hospital.

Speaking of which, my CERT training is that in a mass casualty situation (multiple victims), administration of CPR is not contemplated. You essentially separate the quick and the dead, treating massive bleeding and similar cases rather than devote disproportionate resources to those not breathing. It was a bit of a shock to me to confront this strategy, but it does make sense. i hope I never have to follow it.

That's a pretty good ratio. One of my instructors (former law enforcement now EMT) did CPR for ten with two saves, but that's very unusual. Another instructor (former military corpsman, former Paramedic, now law enforcement) said that he'd had one save out of over one hundred attempts.



That's part of the CERT standard nationwide. Our mission is to do the greatest good for the greatest number. The idea is that we'll save more people if we don't invest all the manpower and effort in one or two. As you said, this only applies during a mass casualty event.

Current CPR training de-emphasizes pulse checks. It can be difficult under stress to find a pulse, even when present. The current training for lay-persons is that you look for other signs of life, such as movement or breathing. If the person is not breathing, or is only gasping occaisionaly ("agonal respirations") you still start CPR. People with BLS CPR training, which a nurse would have had, still do pulse checks, but even there pulse checks are de-emphasized.

CPR only buys you (a little) time. Early use of an AED is what saves lives. Even then, as others have observed, the success rate is rather low.