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Section 4: Special considerations
Psychological, emotional, legal and
ethical aspects of providing basic life support.
There is evidence that persons trained
in CPR are often unwillingto perform it -both in and outside
the hospital setting. There are a variety of reasons given
including fear of disease, fear of hurting the victim, fear
of performing the skills incorrectly, and fear of liability
among them. It is important to remember that the risk of getting
disease while giving CPR is extremely low and observing universal
precautions for victims of all ages will make it lower. Fears
associated CPR skill performance can be reduced through regular
participation in quality training that focuses on simple,
practical skills and confidence building. Still, when resuscitation
is attempted, rescuers at all levels experience a wide range
of negative reactions and emotional stress. Failed resuscitation
attempts often leave those who perform resuscitation infrequently
feeling guilt and failure when CPR was not “done right.”
This distress is normal and usually temporary. The tables
on the following pages will help BLS providers appreciate
the common psychological, emotional, legal and ethical aspects
of providing BLS.
Psychological Aspects
Fear:
Hurting victim or performing skill incorrectly
Reality:
Rib and breastbone fractures occur frequently during chest
compressions in adult CPR but are not major complications.
In infants and toddlers, CPR rarely causes such injuries.
Although CPR should be “done right' and with high quality,
it is helpful to remember that a person in cardiac arrest
is dead (without breathing or a pulse). It is hard to make
them “worse.''
The root of the word “resuscitate” is from the
Latin “revivere” and means ”to live again.''
Rescuers who perform high quality CPR in a good faith attempt
to give the victim a chance to live again should not hold
themselves responsible when that attempt does not restore
life fully - or at all.
Mistakes in resuscitation may reduce the chances for successfully
resuscitating the victim, but they do not “|kill'' them.
The majority of adult and child victims of cardiac arrest
are not brought back to life. They stay dead.
Emotional Aspects
Traumatic Stress Reactions are a normal, human response to
a traumatic event and are usually temporary. Symptoms begin
within minutes of the traumatic event and should disappear
within hours or a couple days.
Traumatic Stress Reactions Signs and
Symptoms
During Incident
Anxiety/worry
Trembling/shaking
Sweating
Fast breathing
Pounding heartbeat, shock, anger
Excitement, intense fear
Nausea
Following
Incident
Thinking about event repeatedly / flashbacks
Worry about self or loved ones
Guilt for not having done more or better
Tense muscles, diarrhea/constipation, nausea/vomiting, headaches,
tired.
Avoiding reminders of incident
Easily startled
Lack of interest in usual activities
Sadness, feeling numb/detached
Sleep problems / nightmares
Problems concentrating
Hyperactive / depressed
During Incident
Remain calm and act sensibly
Accept your own limitations as a rescuer.
Following Incident
Remind yourself that stress reactions are normal and will
pass
Get back into a normal routine as soon as possible
Be kind to yourself. Allow time to deal with memories of the
incident
Accept every person’s right to his or her own feelings.
Keep what happened in a realistic perspective
Exercise, eat, drink, and rest
Have a connection to professional resources for continued
care if necessary.
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