CPR doesn’t bring a decompensated body back to life. You gotta figure out the problem in order to do that and fix it. That’s what the algorithms we use in a code is for (as opposed to the algorithms you guys code). That’s the real esoteric necromancy. Epi, bicarb, epi.
Not having a heartbeat and not breathing doesn’t mean you’re dead. Intensive care departments are literally full of people with medically paralysed breathing muscles (i.e. not breathing) on ventilation machines. People go onto heart/lung bypass machines everyday to have heart surgery and their heart is stopped. You just need to keep oxygenated blood going around, keeping those tissues alive till you get the heart and breathing back online (this is what CPR is trying to do).
When the brain stem is dead tissue, then you’re truly dead (but even then you can be kept “alive” artificially if you’re already on a ventilation machine in a suitable intensive care).
The medical community has long since moved on from the cardiovascular definition of death.
UpToDate.com is about the only source I can be bothered mustering up for an internet disagreement at this time of night:
Death is an irreversible, biologic event that consists of permanent cessation of the critical functions of the organism as a whole [1]. This concept allows for survival of tissues in isolation, but it requires the loss of integrated function of various organ systems. Death of the brain therefore qualifies as death, as the brain is essential for integrating critical functions of the body. The equivalence of brain death with death is largely, although not universally, accepted [2,3]. Brain death implies the permanent absence of cerebral and brainstem functions.
Also this video seems to explain what I’m trying to say, although I’m not going to watch the whole thing at this hour and I only skimmed through it: https://m.youtube.com/watch?v=5IhxRSaJ74E
Once upon a time, many moons ago as a resident, I was called at 2 AM by the organ donation team to call the time of death of a beautiful 21-year-old girl who had gone into a diabetic coma and never woke up. There was 20 people in the room weeping, Amazing Grace was playing; I was sweating bullets. So I stood there until her pulse stopped and called it, even though she still had PEA on the monitor. I was so nervous, I followed her into the OR to make sure she didn’t wake up when they cut her.
Usually they’re not dead when that happens. I personally have never had that happen in any of my codes but all my people are connected to continuous cardiac monitoring so I generally know what’s happening before I even see them.
As an old and retired medic, the lack of respiration and pulse doesn’t mean you are dead-dead. On the scale of "Not Dead to Dead-Dead, a lack of respiration’s and pulse means you are at the maybe dead on the line. And other factors will make the final determination about if you are actually dead or not.
The first determining factor in figuring out where the patient is on the scale, is if you make it into my amp-a-lamps or not. If you do, you are alive at least for a little while longer and I’mma let the doctor sort it all out for you. If you don’t make it in the back of my bus, then you are dead-dead and nothing can change that-- not even god himself.
For all the times I have done CPR or those times I have to deal with a major trauma, never once did I see Jesus there waiting to take a turn at chest compressions, I never once saw the Holy Ghost crawl into an upside down car wreak with me, and God sure as hell was not there when I had to scale up out of that 20ft deep drainage ditch and had to explain to a Mother that her 11 year old son was dead under that 4-wheeler and there was nothing anyone could do to fix that.
That’s a story from thousands of years ago. I don’t think their standards for 1. Death; or 2. Veracity in stories were up to the standards we would like were it non fiction
CPR doesn’t bring a decompensated body back to life. You gotta figure out the problem in order to do that and fix it. That’s what the algorithms we use in a code is for (as opposed to the algorithms you guys code). That’s the real esoteric necromancy. Epi, bicarb, epi.
https://hospitalhandbook.ucsf.edu/04-comprehensive-acls-algorithm/04-comprehensive-acls-algorithm
But they are literally dead
Not having a heartbeat and not breathing doesn’t mean you’re dead. Intensive care departments are literally full of people with medically paralysed breathing muscles (i.e. not breathing) on ventilation machines. People go onto heart/lung bypass machines everyday to have heart surgery and their heart is stopped. You just need to keep oxygenated blood going around, keeping those tissues alive till you get the heart and breathing back online (this is what CPR is trying to do).
When the brain stem is dead tissue, then you’re truly dead (but even then you can be kept “alive” artificially if you’re already on a ventilation machine in a suitable intensive care).
When your heart stops, you are considered dead no matter how viable your brain tissue is.
Source: I have pronounced many persons dead.
The medical community has long since moved on from the cardiovascular definition of death.
UpToDate.com is about the only source I can be bothered mustering up for an internet disagreement at this time of night:
Death is an irreversible, biologic event that consists of permanent cessation of the critical functions of the organism as a whole [1]. This concept allows for survival of tissues in isolation, but it requires the loss of integrated function of various organ systems. Death of the brain therefore qualifies as death, as the brain is essential for integrating critical functions of the body. The equivalence of brain death with death is largely, although not universally, accepted [2,3]. Brain death implies the permanent absence of cerebral and brainstem functions.
Also this video seems to explain what I’m trying to say, although I’m not going to watch the whole thing at this hour and I only skimmed through it: https://m.youtube.com/watch?v=5IhxRSaJ74E
Once upon a time, many moons ago as a resident, I was called at 2 AM by the organ donation team to call the time of death of a beautiful 21-year-old girl who had gone into a diabetic coma and never woke up. There was 20 people in the room weeping, Amazing Grace was playing; I was sweating bullets. So I stood there until her pulse stopped and called it, even though she still had PEA on the monitor. I was so nervous, I followed her into the OR to make sure she didn’t wake up when they cut her.
Have you considered pronouncing them based on the spelling of their names?
I know this is a definition in many places. I find it stupid and useless.
No it’s not. It only becomes a criteria when you can no longer reasonably be sure that it can’t be restarted.
Source: Retired medic that has pronounced my share of dead people AND restarted a few hearts also.
This is like saying your car battery isn’t dead because I’m able to jump start it.
So why do we do CPR? Why do we use AEDs? Was all the CPR I have done a waste of time?
Dead means you are going to stay that way. Dead is irreversible. And until I and/or a doctor say you are dead, you are not. You are just maybe dead.
Dead means dead if you don’t do anything about it
Thanks for pointing that out Captain Obvious. And I earned the tee shirt for needing to make that decision-- more than once.
And they’ll stay dead if all you do is CPR. CPR alone is closer to necrophilia than necromancy.
Only when you stick your tongue in their mouth.
Which is fun, don’t get me wrong, but sometimes things are busy and you don’t have time.
Sometimes they only need a couple compressions
Usually they’re not dead when that happens. I personally have never had that happen in any of my codes but all my people are connected to continuous cardiac monitoring so I generally know what’s happening before I even see them.
Dead is more of a legal than a biological definition nowadays. There’s definitely some leeway.
being dead is surprisingly flexible with modern medicine
As an old and retired medic, the lack of respiration and pulse doesn’t mean you are dead-dead. On the scale of "Not Dead to Dead-Dead, a lack of respiration’s and pulse means you are at the maybe dead on the line. And other factors will make the final determination about if you are actually dead or not.
The first determining factor in figuring out where the patient is on the scale, is if you make it into my amp-a-lamps or not. If you do, you are alive at least for a little while longer and I’mma let the doctor sort it all out for you. If you don’t make it in the back of my bus, then you are dead-dead and nothing can change that-- not even god himself.
Jesus would like a word with you.
For all the times I have done CPR or those times I have to deal with a major trauma, never once did I see Jesus there waiting to take a turn at chest compressions, I never once saw the Holy Ghost crawl into an upside down car wreak with me, and God sure as hell was not there when I had to scale up out of that 20ft deep drainage ditch and had to explain to a Mother that her 11 year old son was dead under that 4-wheeler and there was nothing anyone could do to fix that.
God ain’t never had anything to do with it.
That’s a story from thousands of years ago. I don’t think their standards for 1. Death; or 2. Veracity in stories were up to the standards we would like were it non fiction