Dear Editor,
Re: “Resuscitation order ‘flawed’,” News, Oct. 19.
As a paramedic in the Lower Mainland, I have witnessed first hand the anguish that a loved one’s death can cause family members and my sympathy goes out to the Wang family.
While I am not familiar with the specifics of Mr. Wang’s case, I can say that I have participated in many similar resuscitations outside a hospital setting.
More than 85 per cent of cardiac arrests in Canada occur outside of the hospital therefore it is crucially important for everyone to understand and communicate their wishes regarding advanced directives and do not resuscitate orders to their friends and family.
While guidelines are in place regarding when a resuscitation is warranted, often I have only seconds to decide if those guidelines are met and frequently my decision is based on information from available loved ones.
I urge everyone young and old, healthy and with chronic diseases to have a discussion with their family and primary care provider regarding these important decisions. What makes your life meaningful? What would you like your death to look like? What are the odds of your survival?
While I can’t answer the more personal questions for you, I can inform you of the realities of an out-of-hospital cardiac arrest:
- Nationally, only 4.3 to nine per cent of people will survive. B.C. is slightly better at 14 per cent, which is still less than three people in every 20 victims.
- The greatest chance for survival occurs when a bystander witnesses the cardiac arrest and CPR is started immediately (especially if a defibrillator is present).
- It is unclear if advancing age has any bearing on the survivability of an out-of hospital cardiac arrest.
- The more chronic conditions a patient has (high blood pressure, diabetes, previous heart attack, etc.), the less likely they are to survive.
- Resuscitation commonly involves CPR, which includes chest compressions (may result in broken ribs) and artificial respirations with a mask. A tube may also be placed down your throat to facilitate your breathing, electricity may be used to try and reset your heart rhythm and intravenous access may be obtained to give you medications.
While it may be uncomfortable to read and talk about these things, it can be even worse for your family to have to witness these procedures, not knowing if they are making the right decisions. Please allow your family and myself to honour your wishes and provide you with the care you actually choose. I urge you to visit online at Gov.bc.ca/AdvanceCare, share your decisions with your family and place any important paperwork such as do not resuscitate orders on your fridge where I, and other first responders, can find it.
Christa Renneberg
Richmond
