Customer Reviews

Sudden Death and the Myth of CPR

5 star:		(3)
4 star:		(1)
3 star:		(2)
2 star:		(2)
1 star:		(1)

 

 

Of the roughly 400,000 "sudden deaths" in the United States each year, only about 1-3% of those undergoing CPR outside the hospital survive. This low figure of survival is accompanied by a high price tag, both economically and emotionally. Timmermans takes a candid look at CPR, exposing its myths and problematic areas, and I found his book historically well researched and balanced. I do have some reservations about some of the misleading statements he makes in chapter 5, especially his mistake of treating 'social inequality' as a synonym for 'unjust', accompanied by the false implication that social value affects survival during a hospital resuscitation effort. On the whole, however, he does a fine job and his extensive historical research and interviews with health care workers make this a fine book. It serves as an excellent antidote to the overly optimistic expectations generated by TV shows and CPR training courses.

I loved this book. It is on a painful topic but it answered some nagging questions for me. My mother died unexpectedly and I never forgave my father for not staying with her during her last moments and always wondered why CPR did not keep her alive. This book provided some answers. It is informative and compassionate.

This book has many strong points-the history of resuscitation is an excellent resource in this book. However, I must point out that the author's stances later in the book is slightly confusing- it is hard to see which side the author is "on"- is he Pro-CPR, Pro-CPR only during some situations, or Don't-Do-CPR at all? The concluding statement he makes still confuses me, as he implies that CPR should be done on particular patients...but how would you decide? This statement makes me believe that instead of improving CPR or its adjunts, it is better to decide who lives or dies before a person dies... His three stories on resuscitation events are quite unfair- showing that all of them "failed"; it does strengthen his view, but the familes were all "willing" to accept the patient's deaths- what if the familes were in anger or denial? What is CPR was not done at all- would the familes react differently, as they helplessly stood by? Also, some comments about Paramedics or Nurses seem to critise them, dispite their hard, yet necessary, job. Nevertheless, this book brings a good perspective to CPR and its "myth". Strongly written, it does its best to answer questions about resuscitation and its true face. I will still do CPR if I had to, dispite the book's stance, but I am now more aware and understanding of the probable outcome that is likely to result with my efforts.

Though Timmermans brings up many valid issues in this book, I disagree strongly with the idea of "restoration of dignity to sudden death". This seems like a make-nice way of saying not to upset family members with chest smacking and electric jolts of defibrillation.

Please! Dignity is for bystanders who don't want their sensibilities upset, not for the guy on the stretcher. I know. I was that guy. I may hold the world record for being revived. During a massive heart attack, I was defibrillated 72 times. It took almost three hours of work to bring me back. And guess what? I wasn't the slightest bit concerned with dignity. I just wanted them to keep working until they got me back.

Did I care if my chest was fried from the voltage? No.

Did I care that they stripped me and half a dozen people were handling me? No.

All I cared about was getting back so I could see my wife and I didn't give a tinker's damn what they did to me. Now, it's five years later and I am healthy.

Yes, only a fraction of people who arrest survive resuscitation. But some do. Resuscitation, by definition, is a last-ditch, desperate measure. Admittedly, most victims won't make it. But that's not why we do it. We do it for the ones who DO make it....

This was a very interesting and thought provoking book. The public's perception of CPR is that once the paramedics arrive, everything will be OK, but Timmermans shatters this myth. Depictions of resuscitation on shows such as 'ER' show success rates of 75%, when in reality success rates are as low as only 1%. Through observations and many interviews we are shown how health care workers regard the protocols and how resuscitations are actually carried out in real life. This book should be required reading for anyone who has taken a CPR course.

I work in emergency medicine and was sure I would hate this book. But I actually like it very much. Timmermans gives a nuanced and empathetic view of resuscitating. He explains how paramedics and emergency room staff are trapped in a double bind. Relatives expect them to save lives but resuscitation techniques rarely succeed in saving lives. The result are unrealistic expectations. Timmermans does a good job exploring the colorful history of resuscitation techniques and the role of insurance companies and managed care. I only wish he paid more attention to automatic defibrillators.

If you have any medical knowledge in resuscitation, there are some glaring examples in the book that the author really doesn't know what happens in a resuscitation event. Examples like:
1)"Knickerbocker...noticed that the dogs' blood pressure would increase when he put the heavy fifteen-pound paddles" (50)
2)"...or a prolonged pulseless anginal rhythm..." (122)
3)"LANKER: She must not even have a 60 [heart rate]. JOHNSON: Well, I feel a carotid [pulse]. So it should be at least a 60." (142)

While these examples seem small, the inaccuracies can seriously damage the author's credibility. Using the above examples, here's why:
1) The paddles DID NOT weigh fifteen pounds! The doctor needed to APPLY 15 POUNDS OF PRESSURE to the dogs chest to activate a safety switch. This is what caused the blood pressure to suddenly peak in the dog. We still apply several pounds of pressure to defibrillator paddles today; if the author had read a advanced cardiac resuscitation book he would learn of this.
2)Angina is the wrong word. Angina, or "heart pain" has nothing to do with the situation. Rather, the word should be "agonal" which means "dying".
3)When the nurse here says "60", she is not referring to the heart rate, but blood pressure. (We know this by reading the next line.) There is a big difference between the two, and the difference has clinical significance. (Traditionally, a carotid [neck] pulse, which is mentioned in the next line, indicates that the blood pressure is at least 60mmg.)

The book comes to some very strange conclusions ("Mouth to mouth remains an unarousing sexual act" Page 93) and some vivid and imaginative descriptions of CPR. ("CPR is unusual in the way it brings strangers into intimate contact. First the rescuer "kisses" the unconscious person, then "hits" the person hard. We love life, hate death, love life, hate death in a perpetual rhythm." Page 93)

This is obviously a well-intentioned book, but I feel disappointed in the many mistakes, strange conclusions and unrealistic suggestions. (The author suggests that everyone should carry some form of ID that states whether or not they want CPR done to them. Not only would this be a logistical nightmare, what happens if the card isn't with the person? Will rescuers fear helping people just because they don't have a card? Terrible and frightening idea!)

This is a more of a "thinking" book...it gets you thinking. But if one believes that the book shows all the sides of resuscitation, they are wrong...

The author is writing in detail about something he has no medical understanding of. The author researched and interviewed but does not understand.

True: CPR does not often bring the dead back to life, and sometimes when it does, the return of spontaneous circulation does not last long enough for the person to ever leave the hospital. And yes, it is costly. However, sometimes it DOES work, and people return to their normal lives without any neurological deficit. This fact says that CPR is worth doing. The author goes on and on about cost, seeming to suggest that since it usually doesn't work, we shouldn't bother trying. I can't imagine preaching the pointlessness of a technique that can return a human being to normal living. I can't imagine anyone who has experienced death of a loved one putting a price tag against the possibility (however slight it may be) of having that person back. You cannot compare the value of a human life to any statistic or dollar amount...unless you wrote this book...

While their are some ethical issues that do need discussion I really wonder if the authors if took a CPR class. After being a First Aid/CPR/AED Instructor for the American Red Cross since 1986 Ican tell you that in a CPR and on the test it plainly states the objective of CPR is circulate blood containing oxygen throughout the body, especially, to the vital organs to prevent permanant damage until advanced life saving care can be provided. It's a stop gap until EMS arrives. This book is much ado about nothing.