March 6, 2013

Not Even a Little CPR?

Some news dominating the headlines is a story about a nurse at an assisted living facility in California who refused to perform CPR during her 9-1-1 request for aid. The tape of that shocking conversation is making the rounds.

I love case studies, and this one’s a whopper. It teaches not only an ignorance of the law and the price some pay for anther’s ignorance, but it also shows as tragically the loss of life.

I am speaking of how a refusal to aid another is an equivalent of gun bans and on the same grounds of willful ignorance.

We are hearing now that the facility – Glenwood Gardens in Bakersfield, California – has a policy against administering CPR to residents who retire there. The reason given for this cold policy is apprehension of lawsuit, we are informed. Let me borrow from my concept The CPR Corollary.

Years ago, I developed a concept I called The CPR Corollary. In short, it is that the ubiquitous armed citizen is as vital to a community as the CPR-trained Good Samaritan is. It is not only a matter of being armed, but more of a values system of integrity in a person realizing one’s citizen dual duty to community. Anyone can grasp this concept and how it operates in the absence of first responders. It does this in public policy, public interest, good citizenship, codified law, substantive law and just plain decency.

When CPR was developed in 1960 at Johns Hopkins, it was envisioned that it could save lives in the hospital. It bloomed into a method of averting premature death for a host of conditions not even heart related initially, such as electrical shock injury, falls, beatings, wounds, allergic reactions – any time the heart stops. It also teaches laymen the Heimlich Maneuver, the anti-choking abdominal thrust move any bystander can carry out in a choking incident.

But the CPR Course for Instructors such as myself in the seventies included addressing the legal component of concern.

My authority was the American Heart Association. In my generation (the seventies) all Paramedics graduated were CPR Instructors among other certifications. That legal component was addressed this way: The Association posted an interrogatory to the American Bar Association on the foreseeable liability for administering CPR. The ABA responded this way (paraphrased). 1. There is no causal relationship between the emergency condition (cardiac arrest) and the bystander; if anything, the bystander can only improve the condition which, without their intervention, results in certain death. 2. The injuries sustained during CPR are negligible compared to certain death, and are often incurred even under the best of circumstances, and 3. The idea of lawsuit for such an important practice would run counter to established public policy and interest.

Today, that this question has been satisfied is evidenced by widespread CPR training for laymen, the placement of Automatic Emergency Defibrillators (AED’s) at workplaces and airports, for instance, and the very widespread publicity of new CPR technique disbursed purely for the layman. As another example, many laymen know today that the new CPR Techniques is the compressions-only method.

If an institution makes it policy to refuse to intervene for legal purposes, one may incur a greater liability than one is trying to avoid.

How this parallels gun bans and no-guns policies is in the emergence of both unchecked shootings we see in so-called gun-free zones and lawsuits against the gun ban itself, especially in regions where the armed citizen is commonplace. More and more of those suits show the second amendment advocates prevailing.

I have posted many times that gun bans makes about as much sense as denying adult college students the knowledge and latitude of administering First-aid and CPR until EMS arrives. Now we have both gun bans and denying care policies.

Without the directive in hand beforehand – and the report claims that there is none on record – the refusal to administer CPR as a matter of policy even to an 87-year old woman reflects an ignorance comparable to gun bans which so very stubbornly wind up hurting more than they will ever protect. Without the advance directive of one form or another beforehand, such a policy runs counter to the interests of the clients. Does this No CPR policy also apply to employees there?

Here’s another Zero IQ policy – I mean Zero Tolerance policy: School boys who disarmed another student who was pointing a loaded .22 handgun at another; punished for that with suspension.

I state that the armed citizen is as valuable to the community as much as the CPR-trained is. Denying CPR and gun bans: they’re identical.

John Longenecker is author of The CPR Corollary. John and his wife Aurea operate

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