What do you do when CPR doesn’t work? Unfortunately, many people who suffer cardiac arrest do not survive, even despite receiving immediate help. This can cause rescuers to feel guilty or question whether they did something wrong.
For one ProTrainings student, the guilt and anxiety from performing CPR on someone who did not survive resulted in many sleepless nights. Then, one of our training videos helped them gain an important perspective on the purpose of CPR and what it really means to perform CPR successfully. For the first time since the incident, the student slept peacefully.
If you or one of your staff members has experienced those same feelings of guilt, we hope this perspective can help bring you peace, as well. If you have not yet had to perform CPR, we hope it can help prepare you to provide lifesaving aid with confidence instead of fear.
Here’s what you need to know about the true purpose of CPR and how to prepare yourself and your staff for when CPR doesn’t work.
What People Get Wrong About CPR
Often, the guilt or doubt people feel when CPR doesn’t work stems from the common but mistaken beliefs that CPR:
- Is a guarantee for saving lives
- Acts as artificial life support
- Keeps the person alive for as long as CPR continues
These misconceptions treat CPR as a cure for cardiac arrest, a medical procedure that stops a person from dying. As a result, when CPR doesn’t work, the rescuer feels as though they have failed to provide that cure.
In reality, CPR does not stop a person from dying. At the moment of cardiac arrest, the person stops breathing and their heart is unable to circulate blood and oxygen. When this happens, they are already clinically dead — but that doesn’t necessarily mean they will remain that way.
Rather than preventing death, CPR simply slows down the process of biological death, buying time until help arrives.
What CPR Actually Does
If CPR isn’t a lifesaving treatment, then what is it? Essentially, it’s a time-buying measure designed to give the victim the best possible chance of survival.
To understand this, it’s helpful to understand how CPR works physiologically.
When a person suffers cardiac arrest, their heart is no longer pumping blood out to the brain and the rest of the body. CPR manually pumps blood through the heart to mimic the natural circulation process, but it can only do so at a fraction of the normal efficiency.
This means that even when CPR is performed perfectly, it only delivers a small percentage of what the body needs to survive. In many cases, it buys enough time for medical professionals to administer defibrillation, oxygenation, advanced life support, or medication and address the underlying cause of the cardiac arrest.
Why CPR Sometimes Doesn’t Work
Whether a person will or won’t survive cardiac arrest depends on many factors, including but not limited to:
- The cause of the cardiac arrest
- Response time from bystanders and medical professionals
- Medical intervention
Not all cardiac arrests are survivable, and even technically perfect CPR does not guarantee a positive outcome. In other words, just because the victim did not survive does not mean the rescuer failed.
Every person has a day they will pass away. All we as rescuers can hope to do is give them the best chance at surviving — because without CPR, it is almost guaranteed that they won’t survive.
Remember, a victim of cardiac arrest doesn’t die when CPR doesn’t work — they simply remain dead.
What Matters Most: The Gift of Trying
Although the ideal outcome would be for every victim of cardiac arrest to survive, the true objective of performing CPR is the action itself. By attempting CPR, you or your staff are making a profound human effort to give a colleague, a loved one, or even a stranger a chance to live. That’s an incredible gift!
Recent studies have shown that cardiac arrest victims may have some level of cognitive activity and awareness of what is going on around them.
Some survivors have even reported remembering part of the resuscitation process or hearing the voices of loved ones calling them back from death. Many — like Minnesotan Jay May, whose life has been saved by CPR twice — express overwhelming gratitude for their rescuers.
Consider this: Even if the victim does not survive, their last memory could be the knowledge that someone cared enough to try to save their life.
It’s normal to feel guilty when CPR doesn’t work. But focusing on effort over outcome may help you find peace in knowing that you did the best you could to help a person in need — and that is enough.
How to Prepare Your Staff for When CPR Doesn’t Work
Don’t wait until after an emergency has occurred to help your staff understand how to deal with scenarios when CPR doesn’t work. Build that support into your CPR training process so they’re prepared well in advance.
- Explain up front: Clearly address the misconceptions about the purpose of CPR from the beginning. For example, one ProTrainings CPR instructor plays the “When CPR Doesn’t Work” training video at the start of each class to set the tone and manage students’ expectations.
- Reinforce effort over outcome: Emphasize that any attempt to administer CPR is a success and an act of care — never a failure.
- Stress CPR’s role in survival: Remind your staff that CPR is an intervention used to slow down biological death when a person has already suffered a clinical death. It is not artificial life support that stops a person from dying, and you cannot make the victim worse by attempting CPR. But you can potentially buy them valuable time.
- Address emotional impact: In its 2020 “Guidelines for CPR and ECC,” the AHA notes that debriefings and counseling may be beneficial as “rescuers may experience anxiety or posttraumatic stress” regardless of whether they attempt CPR. Ensure your staff know this support is available in advance, as well as how and where to access it.
Regardless of the outcome, cardiac arrests can be distressing for both the victim and the rescuers. By correcting misconceptions and offering emotional support up front, you can help prepare your staff to save lives with confidence.
How to Build Confidence Instead of Fear
While fear of failure and feelings of guilt when CPR doesn’t work are common, they don’t have to prevent you or your staff from offering lifesaving aid to an emergency victim.
The key to fostering a culture of CPR confidence instead of fear is to help your staff understand what CPR really is and isn’t and that the act of attempting CPR is itself a success, regardless of the outcome.
As you prepare your staff to respond to emergency situations, do your best to ensure they are not just trained in how to perform CPR but also emotionally supported in their critical roles.
Contact us today to learn more about how ProTrainings can help you make getting your staff CPR trained — and supported — easier and more efficient.