Can you get sued for attempting to administer CPR?

[Snow1964]

Can confirm - I have called 999 on mobile as first at the scene of a car crash before (2-3 yrs back?) and was asked to give location - as I was doing so, the call handler said "Ok - I can see your location from your phone now", so clearly they had suitable data, regardless of number called.

It depends on network strength where you are, in busy areas probably ok, but in many more rural areas probably get a single phone mast, not 2 or 3 so they can't triangulate.

Obviously if only in range of a single mast, can be in any direction from it.

I lead rural walks once every 2 months and we have been asked to download what3words because it gives accurate location even when in a footpath in woods or across a field, so can give location in an emergency. Fortunately no one has needed CPR in middle of nowhere.

 

[JamesT]

It depends on network strength where you are, in busy areas probably ok, but in many more rural areas probably get a single phone mast, not 2 or 3 so they can't triangulate.

Obviously if only in range of a single mast, can be in any direction from it.

I lead rural walks once every 2 months and we have been asked to download what3words because it gives accurate location even when in a footpath in woods or across a field, so can give location in an emergency. Fortunately no one has needed CPR in middle of nowhere.

As I understand it, unless you have a really old phone then the location data comes from the phone’s GPS, rather than the cell towers.

 

[Bletchleyite]

I lead rural walks once every 2 months and we have been asked to download what3words because it gives accurate location even when in a footpath in woods or across a field, so can give location in an emergency. Fortunately no one has needed CPR in middle of nowhere.

W3W is an awful piece of technology and needs to go in the bin. A very slight misunderstanding can put you the other side of the world.

What does get me is why the ambulance service can't deal in OS grid references. All they want, from experience, is a postcode, and in rural areas there may not be a useful one or it may cover a very large area. I have been in that situation and the best I could do was "go to the Galleon pub and walk down the towpath towards Stony Stratford", and they weren't even overly happy with that. I don't think W3W existed then, but equally it is really not particularly good.

 

[styles]

As I understand it, unless you have a really old phone then the location data comes from the phone’s GPS, rather than the cell towers.

Basically yes. Unless the phone was made over a decade ago, it'll use Advanced Mobile Location (AML) which pings an accurate location to emergency call handlers. If wifi/GPS/location services are disabled, AML will temporarily switch them back on to get an accurate pin, send it, then disable them again. The difference is stark: https://www.secamb.nhs.uk/wp-content/uploads/2023/08/220805-FOI-AML-W3W-references-.pdf

 

[ainsworth74]

I used to do a St Johns Ambulance first aid course annually for work, but I gave it up a couple of years ago as it was just getting to silly. In the last one I did we were instructed the same as you with regards to bras (except the trainer referred to "people with breasts" rather than women, which wound me up no end). Also, got told that we couldn't touch people of the opposite sex unless we had consent. So in the exercises about putting people in the recovery position we had to actually ask them first "Do I have consent to touch your body to put you in the recovery position?". Which would obviously be completely pointless in a real-world situation.

That's interesting as I've been doing St Johns for my first aid training (the one day emergency first aid at work, don't need the full fat three day course first aid at work course) and of the last three trainers I've had there's been nothing like that. They've all emphasised thinking about your casualties dignity (cover them up if you've removed clothing or they've soiled themselves, etc) but nothing about asking unconscious people for consent to move them. The advice was say out loud what actions your taking "I'm going to move you into the recovery position now, I'm just going to grab your leg and move it up, and now we're going to move you over" etc etc. But nothing about asking permission first. Can't remember what gender stuff if any was used (but then that doesn't wind me up like some people so I don't pay attention).

The last three trainers I had were a grizzly veteran, a young lass in her mid-20s and then a fella in his 30s who worked for the local Ambulance service. They all took very similar approaches to each other.

Can't say I've noticed any "wokery" creeping in.

 

[Lloyds siding]

That's interesting as I've been doing St Johns for my first aid training (the one day emergency first aid at work, don't need the full fat three day course first aid at work course) and of the last three trainers I've had there's been nothing like that. They've all emphasised thinking about your casualties dignity (cover them up if you've removed clothing or they've soiled themselves, etc) but nothing about asking unconscious people for consent to move them. The advice was say out loud what actions your taking "I'm going to move you into the recovery position now, I'm just going to grab your leg and move it up, and now we're going to move you over" etc etc. But nothing about asking permission first. Can't remember what gender stuff if any was used (but then that doesn't wind me up like some people so I don't pay attention).

The last three trainers I had were a grizzly veteran, a young lass in her mid-20s and then a fella in his 30s who worked for the local Ambulance service. They all took very similar approaches to each other.

Can't say I've noticed any "wokery" creeping in.

Carrying on a running commentary is useful to cover yourself so that nothing happens that patients and bystanders weren't expecting...but it is the patient that benefits most. People who are unconscious/semi-conscious may not be able to move or see, but they can often still hear. (I know because I've been a patient...being told what is happening, or about to happen, is really useful and reassuring, especially when you are not in a position to do something for yourself.)
I've also been at the other end:-
Having performed CPR on a cold lifeless patient with no pulse, the last thing I was worried about was whether I may break some ribs...as it was he survived, and the hospital passed on a message to say well done to the first aiders. If you can do CPR do it!

 

[Bletchleyite]

The other thing about CPR worth mentioning is don't expect for it to be like a film where you do it and they come back round. They almost certainly will not - you are just keeping their brain alive until a defibrillator arrives that has a chance of getting things going again.

The exception to this is near-drowning, where doing CPR may (but won't necessarily) eject enough water from the lungs to allow them to start breathing again and in due course, as their oxygen levels rise, become conscious.

 

[ainsworth74]

Carrying on a running commentary is useful to cover yourself so that nothing happens that patients and bystanders weren't expecting...but it is the patient that benefits most. People who are unconscious/semi-conscious may not be able to move or see, but they can often still hear. (I know because I've been a patient...being told what is happening, or about to happen, is really useful and reassuring, especially when you are not in a position to do something for yourself.)

Absolutely that was the explanation given for why to keep a running commentary going. They might not be able to move or see but they may very well hear you so saying what you're doing can be a massive reassurance to them! Quite apart from any other concerns. I'm glad that it worked as intended for you in what I'm sure was a very scary situation.

I've also been at the other end:-
Having performed CPR on a cold lifeless patient with no pulse, the last thing I was worried about was whether I may break some ribs...as it was he survived, and the hospital passed on a message to say well done to the first aiders. If you can do CPR do it!

Thankfully I've not yet (touching all the wood around me!) had to do CPR for real but I agree the last thing that's of worry to me is breaking ribs. Rather break someone ribs and help keep them alive than the alternative. Well done on making a difference!

 

[Lloyds siding]

The other thing about CPR worth mentioning is don't expect for it to be like a film where you do it and they come back round. They almost certainly will not - you are just keeping their brain alive until a defibrillator arrives that has a chance of getting things going again.

The exception to this is near-drowning, where doing CPR may (but won't necessarily) eject enough water from the lungs to allow them to start breathing again and in due course, as their oxygen levels rise, become conscious.

Exactly, my patient was still cold, yellow, unconscious with no pulse when I started the CPR and when the paramedics took over a few minutes later, however we two first aiders had kept him alive and given him a sporting chance. Don't give up, do what you can!

 

[4COR]

It depends on network strength where you are, in busy areas probably ok, but in many more rural areas probably get a single phone mast, not 2 or 3 so they can't triangulate.

Obviously if only in range of a single mast, can be in any direction from it.

I lead rural walks once every 2 months and we have been asked to download what3words because it gives accurate location even when in a footpath in woods or across a field, so can give location in an emergency. Fortunately no one has needed CPR in middle of nowhere.

We are in a fairly rural location as well - mobile reception is hit and miss on occasion, and yet it still worked: my memory is sketchy (and I can't find a video/picture to show it), but I have a feeling on my phone it showed the coordinates on screen as part of the focused calling mode). Android has had the Emergency Location Service for many years, iOS has had Advance Mobile Location since iOS v11.3 (2017 release). More recent phones (eg my Pixel 10) also have features like satellite SOS.

Obviously, very old phones may have to rely on triangulation, but the vast majority of modern phones will, as a default setting (unless a user explicitly turns ELS/AML off), try to determine their location in the best way during an emergency, even if location services are turned off.

 

[Mattplans]

This thread reminds me of a case from 'across the pond' where a patient had "DO NOT RESUSCITATE" tattooed to their chest.

Even in this situation, they sued for the medical charges after the unwanted resuscitation and were awarded damages + medical costs.

 

[adc82140]

This thread reminds me of a case from 'across the pond' where a patient had "DO NOT RESUSCITATE" tattooed to their chest.

Even in this situation, they sued for the medical charges after the unwanted resuscitation and were awarded damages + medical costs.

That wouldn't fly in this country. We are told (I am ILS trained, that's Immediate Life Support for a hospital environment) that no matter what anyone tells you about a Do Not Attempt Resuscitation order, unless you have the proper legal bit of paper in front of you, then you carry on with resuscitation.

 

[Mattplans]

That wouldn't flying this country. We are told (I am ILS trained, that's Immediate Life Support for a hospital environment) that no matter what anyone tells you about a Do Not Attempt Resuscitation order, unless you have the proper legal bit of paper in front of you, then you carry on with resuscitation.

That's interesting, I wonder if this policy will change when the Terminally Ill Adults (End of Life) Bill is passed.

 

[MargaretNoodle]

I've recently done my ALS course (Advanced Life Support) and am a volunteer with St John Ambulance as well as having worked in Cardiac ICU. So this is a really interesting thread for me.

Just as everyone is saying there really is no chance of being sued for performing CPR, but what I think hasn't been mentioned yet, all the survivors of CPR I have met have been so very grateful for the people that saved their life. I think it's very much exaggerated the idea that people who have been successfully resuscitated would even think about sueing their rescuer.

Also in regards to the comments about gaining consent for touching patients when putting them in the recovery position. I suspect, based on having seen similar, that this was about getting permission to touch your (pretending to be unconscious) partner in the first aid course, not that you would do this in real life. But as has also been said it's never a bad idea to verbalise what you're doing and can help to calm you down in these situations.

 

[Exilem]

All defibs should come with tuff cut scissors in the box for just this purpose. There is no need to remove the bra for initial CPR, but as soon as a defib becomes involved it should be off. Nobody should be ferreting around trying to unfasten, just snip it off.

My other bugbear: people saying that you need to be trained to use a defib. You categorically do not. I had a serious go at our Town council on Facebook when they said that you did.

I agree.
The key thing to remember is Effective CPR and early defibrillation improve chances survival in cardiac arrest.

A bra would not interfere with CPR although it might with delivering a shock from a defibrillator. A bra certainly does get in the way of applying the defibrillator pads correctly.
Automatice External Defibrillators are the ones most ofter found outside a hospital. They are designed to be used by a novice with written and spoken instructions (although the 999 handler may be able to talk through) and will not deliver a shock unless the heart rhythm matches one that is shockable. At this point the AED might announce "shock advised" and a warning to stand clear from the patient. It is therefore difficult to cause harm with one if the instructions are followed. An AED does not require prior training and if you are the bystander and have a person in front of you in cardiac arrest all you can do is your best. Bear in mind that early defibrillation will increase the chance of survival.

Hospital defibrillators are usually significantly less automated (although some do have AED modes) and therefore staff have to be trained in their use.

 

[35B]

That wouldn't fly in this country. We are told (I am ILS trained, that's Immediate Life Support for a hospital environment) that no matter what anyone tells you about a Do Not Attempt Resuscitation order, unless you have the proper legal bit of paper in front of you, then you carry on with resuscitation.

Which raises other questions, knowing a couple of people who had DNR orders in place, with the agreement of them and their spouse, because their underlying condition (physical and mental) meant that resuscitation would be an act of cruelty.

That's interesting, I wonder if this policy will change when the Terminally Ill Adults (End of Life) Bill is passed.

It shouldn't need to; the legislation is about a specific set of arrangements.

 

[adc82140]

Which raises other questions, knowing a couple of people who had DNR orders in place, with the agreement of them and their spouse, because their underlying condition (physical and mental) meant that resuscitation would be an act of cruelty.

The underlying rationale is that the consequences of not attempting resus on a person who does not have a valid DNAR in place is far worse than attempting resus on a person that does.

Someone can always shout at you to stop if you are resuscitation when you shouldn't be, but the other way round it'd be too late.

 

[35B]

The underlying rationale is that the consequences of not attempting resus on a person who does not have a valid DNAR in place is far worse than attempting resus on a person that does.

I get and respect the rationale. My concern is that such powerful orders should only be put in place with the full and active agreement of both patient and family, and it is then incumbent on those associated with their care to ensure that the orders are respected - with both sides of that equation being equally important.

Having known one person subject to one, with severe cardiac issues and dementia, the much overused phrase "worse than death" comes to mind about the long term consequences were he to have received CPR.

 

[adc82140]

On a ward, all staff will be aware and respect it. But outside the hospital environment, nobody would know, and a just a relative stating that there is a DNAR in place wouldn't hold up to legal scrutiny. Playing devils advocate for a second, that relative for all anyone knows could be taking the opportunity to hasten the demise of a rich relative.

 

[35B]

On a ward, all staff will be aware and respect it. But outside the hospital environment, nobody would know, and a relative stating that there is a DNAR in place wouldn't hold up to legal scrutiny. Playing devils advocate for a second, that relative for all anyone knows could be taking the opportunity to hasten the demise of a rich relative.

Agree - which is why I used the phrase "all those associated with their care".

 

[styles]

This thread reminds me of a case from 'across the pond' where a patient had "DO NOT RESUSCITATE" tattooed to their chest.

Even in this situation, they sued for the medical charges after the unwanted resuscitation and were awarded damages + medical costs.

I don't think a tattoo like this can really be relied upon to take the place of formal DNR orders with whatever the legal system requires. It's even making an assumption that the person consented to getting the tattoo, or that it isn't poking fun at other DNR tattoos or similar. There's a reason most legal systems will require quite a detailed process to go through, with witnesses etc.

 

[JohnMcL7]

I used to do a St Johns Ambulance first aid course annually for work, but I gave it up a couple of years ago as it was just getting to silly. In the last one I did we were instructed the same as you with regards to bras (except the trainer referred to "people with breasts" rather than women, which wound me up no end). Also, got told that we couldn't touch people of the opposite sex unless we had consent. So in the exercises about putting people in the recovery position we had to actually ask them first "Do I have consent to touch your body to put you in the recovery position?". Which would obviously be completely pointless in a real-world situation.

It seemed that First Aid was just becoming too PC, so I decided to pass the mantle onto someone else!

The course I was on highlighted a number of times that one of the biggest problems with people giving first aid is hesitancy to touch the casualty and he frequently would bring this up that if the person is likely to die, you can't do anything worse. When he asked what is the worst outcome and people answered they might paralyse the person or do other damage, he kept replying no the worst outcome is they die if you don't help them. He also mentioned his frustration at times with AEDs when workplaces wanted to train certain people on them because the point was anyone can use one and getting an AED in use quickly is absolutely vital for the chances of that person surviving.

Can confirm - I have called 999 on mobile as first at the scene of a car crash before (2-3 yrs back?) and was asked to give location - as I was doing so, the call handler said "Ok - I can see your location from your phone now", so clearly they had suitable data, regardless of number called.

And yes - the last 1st Aid course I did also said about underwired bras and need to remove before defib; and they also said about the breaking of ribs (which again, sadly, from experience can confirm is true and while unpleasant, oddly reassuring that you are doing something right at the time...CPR is very hard work, esp if on your own while someone else is off getting the defib.). Clearly some trainers are better than others.

I certainly think the last trainer I had was good and I came away feeling like it had been a very useful day. He was very honest about CPR showing graphics of the person's chance of success based on the time they received CPR, the time an AED is used and then the time for the medical response - even in ideal circumstances, the chances aren't that high but they quickly drop when the response times are longer. He explained about CPR being hard work to sustain and you'd likely need someone else to alternate with (and help manage the AED) so if you found someone needing CPR with no AED nearby and no chance of a quick medical response then you're just not going to be able to maintain CPR. I live in a location with a lot of countryside around here so that is certainly a possibility and a friend did come across someone in this situation who couldn't be saved which was really hard on them mentally.

 

[AlterEgo]

It depends on network strength where you are, in busy areas probably ok, but in many more rural areas probably get a single phone mast, not 2 or 3 so they can't triangulate.

Obviously if only in range of a single mast, can be in any direction from it.

I lead rural walks once every 2 months and we have been asked to download what3words because it gives accurate location even when in a footpath in woods or across a field, so can give location in an emergency.

You've been asked to download it becase W3W wants to charge emergency services a fortune to use it despite it solving no real-world problem. Technological snake oil, and full of issues.

https://www.reddit.com/r/911dispatchers/comments/olcxdv/what3words_and_why_its_trash/

 

[Cdd89]

911 (the latter is I understand mapped on UK mobile networks as why would you not?)

I remember being quite young, calling 911 on my mobile phone to see what service it was assigned to (I was interested in trying every service number and short code I could think of), and being rather embarrassed at getting through to the emergency services. But yes, it is.

Now I think about it, an emergency service telephone number is quite an outdated concept. If we were it today, there would just be a button in a standard, easy to find place on mobile devices that connects you. (And of course there is in many cases, but my guess is most manually-placed calls are still connected by dialling "999").

W3W is an awful piece of technology and needs to go in the bin. A very slight misunderstanding can put you the other side of the world.

Isn't the argument that this is the benefit of W3W. It makes minor mistakes obvious; a sort of built-in error correction. If you've got a faster way to verbally communicate coordinates to a precise location, I'd like to hear it!

The real problem is that it's not an open standard.

 

[35B]

Isn't the argument that this is the benefit of W3W. It makes minor mistakes obvious; a sort of built-in error correction. If you've got a faster way to verbally communicate coordinates to a precise location, I'd like to hear it!

The real problem is that it's not an open standard.

It's also got a reputation for having different locations with very similar names close enough that the error correction doesn't work. The concept is interesting, but I've not found myself using it.

 

[Cdd89]

It's also got a reputation for having different locations with very similar names close enough that the error correction doesn't work. The concept is interesting, but I've not found myself using it.

Yep, it clearly needs a "v2". Maybe "what four words", with the homophones removed.

I agree on not using it much, it's a pretty niche use case. I'm usually corresponding electronically, in which case sharing the actual coordinates (likely via an app) is going to be superior.