How long do hospitals normally keep resusitating hearts?

[scrummyyummy]

I'm very pleased that Muamba is now on the road to recovery after his cardiac arrest and it got me thinking and wondering......I read the hospital worked on him for 2 hours to get his heart to start pumping of its own accord and they had to shock him 15 times! Would hospitals normally keep trying to resusitate for as long as 2 hours? I was under the impression they try and shock a few times, give adrenaline 2 or 3 times and maybe work on the patient for a bit but if there's no sign, they normally call it a day? If that's the case, are they writing off patients who could have been saved, like Muamba, if they were to carry on for 2 hours or more? If the doctors try for say, 10 minutes and decide that nothing can be done, can a relative insist they keep trying?

[rowanwitch]

I wonder if it was external pacing and rapid cooling on arrival at the hospital this can protect brain function as well as maintaining circulation artificially

[Eve]

Quote from Sky News:

"Medics spent 48 minutes trying to resuscitate Muamba between his collapse on the pitch at White Hart Lane and his arrival at hospital, where doctors worked on him for another 30 minutes - a total of 78 minutes.

It took 15 shocks to get the player's heart started again - two on the pitch, one in the tunnel, and another 12 in the ambulance".

[scrummyyummy]

Would Joe Public be given the same length of treatment or would they stop treating after 10 or 15 minutes?

[owdhamer]

in the case of the elderly it could well say dnr

[bednobs]

certainly not 10 or 15 minutes - you can't really do anything in that time. It's an unfair comparison to make anyway because not a lot of people who have cardiac arrests are in their early 20's. Or fit.
There is a tendancy to give up sooner on people who have other medical problems which makes their recovery less likely in my experience

[woofgang]

For a young fit person who they expected to make a good recovery, yes they would carry on trying.

[askyourgran]

My OH asked the same question today, we didn't think anyone could be resuscitated or given shocks for that length of time without incurring some sort brain damage. Good thing they had someone on the pitch to keep him going though.

[237SJ]

I wasn`t here when Muamba came a cropper and I haven`t read anything much about what happened to him. I don`t know anything about the kind of defibrillators they have in hospital but as far as AEDs are concerned, they only work if there is electrical activity in the heart. For example, a person can have no heart beat but there is still electrical activity in the heart (they might be suffering from ventricular fibrillation). The heart is not pumping properly because the electrical impulses that control it are out of synch and the heart quivers. A defib doesn`t actually start the heart. It stops the heart. It stops the haywire electrical impulses so that the heart`s own pacemaker can take over and the heart beats normally again. If there is no electrical activity in the heart, there is no point in defibbing. I presume there was electrical acivity in Muamba`s heart which is why they were able to help him. I presume CPR kept his circulation going until he was defibbed.

[scrummyyummy]

So could a relative insist doctors carry on resusitating a bit longer? (if a patient is middle-aged and not elderly).

[tinkerbell23]

I thought that was long....ive never worked on anyone that long however i looked after an older man once who was shocked 45 times his first time and more later!!!!!!

[scrummyyummy]

237SJ, you've explained that very well, thank you.

[scrummyyummy]

Tinkerbell, wow! 45 times!! I hope he survived?

[slinky.kate]

If this was to happen to anyone else, chances are medics would be within them in less than 20 seconds and giving first aid, there would be 4 - 5 minutes atleast and as there heart had completely stopped it would be completely unlikely that they would make a recovery without permanent brain damage. I reckon if they felt the person could make a recovery they would do as much as they can. Doctors and surgeons are in the job as they want to save lives and if it took 2 minutes or an hour I'm sure they would try as much as they could.

The main advantage is that he went to a private hospital with specialist heart surgeons where as Joe Public would end up at an NHS hospital where the one surgeon would have to pop in between 15 other patients while trying to resuscitate you! As much as I like the NHS, every member of staff is overworked and it wouldn't surprise me if people who could have been saved have died due to a surgeon having to be at two life-threatening patients at the same time!

[Eve]

I'm not a medical person but I'd say it's very hard to generalise this as there could be all kinds of factors involved. There could be all kinds of other things going on (extreme bleeding, difficulties in getting oxygen in, I imagine the possibilities are huge!). Other factors such as age and state of general health and fitness could, I'd assume, factor into how much the body could take in efforts to rescucitate.

I thought maybe his heart rate was coming and going and maybe reacting to shocks, hence the amount of shocks, in order for them to keep shocking, rather than it being completely dead - I have no idea though medically if that's a possibility.

This was a fit young man with, I assume, no recognised serious medical issues intervening as footballers are apparently checked regularly health wise. I'd have thought it had been found he had any kind of condition which meant what did happen might have I'd wouldn't have thought he'd be out on the pitch in the first place.

[bednobs]

relatives couldn't "insist". the doctors cover themselves by doing what is in "the patient's best interests".
No-one can consent to refuse or accept medical treatment on behalf of another adult anyway, unless they have POA

[slinky.kate]

Suppose a relative couldn't insist as they aren't qualified and obviously emotions would be running high and every relative would want them to keep trying! They would be there for hours if every relative kept asking!

[askyourgran]

That sounds reasonable 237sj. My OH had his heart stopped and restarted to try and correct the arrythmia (didn't work). I realise it isn't the same sort of thing, andcertainly not a lengthy procedure, but I can see the reasoning if electrical impulses are there.

[tinkerbell23]

Oh yes then had another two since!!

[DTCwordfan]

They didn't work on me for that long.

Sorry, it was the vet though.

[rowanwitch]

it is likely they cooled his head to reduce his brains demand for oxygen this is apparently having a big effect in reducing damage for those who survive