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IF SOMEONE HAS A DNR THEY ARE FOUND WITH NO
Question: IF SOMEONE HAS A DNR THEY ARE FOUND WITH NO BLOOD PRESSURE (TESTED BY HAND) AND NOT BREATHING , WHEN THEY TEST WITH EKG AND FIND SHE STILL HAS HEARTBEAT DOES THE DNR COME INTO PLAY OR SHOULD THEY TRY TO SAVE HER. (POSSIBLE A DRUG OVERDOSE)
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that if a person has some cardiac activity on the resting ECG he should be resuscitated immediately.
In fact, you should know that manual measurements are not really sensitive when coming to a critically ill patient, compared to ECG machine.
When we do not feel the carotid artery, (and the blood pressure machine shows no pulse), means the blood pressure is less than 60mm Hg. This means that the person is not dead, but he has a too low blood pressure (hypovolemic shock) which can not be registered manually.
The same issue is for the breathing. We usually put our hand on the patient chest to see if it is moving or listen to his breathing. But, in critical ill patients, the breathing may be too weak to be felt.
The same is for the heart rate. Sometimes, we can put our ear on the patients chest (for example : in a road emergency when we do not have any stethoscope, or at home) and the heart beats are too weak to be heard.
For this reason, even when we don't feel the pulse or blood pressure manually, we should try to resuscitate the patient.
So, a resting ECG is a very important tool to evaluate these patients in the ER.
Only when the ECG monitor shows not heart rhythm for a prolonged time, death is confirmed. In such case, other signs of brain death should be evaluated too (pupil size and reaction to the light, oculo-cephalic reflex,, oculo-vestibular reflex, etc..) in order to confirm death.
In case of a drug overdose, the heart rate is too low and the respiration is too weak, so the ECG evaluation is very important.
Even the blood oxygen saturation monitor is not an accurate tool, as it does not show the oxygen saturation when the blood pressure is too low, because there is peripheral vessel constriction in the extremities and it will show no values, although the patient is still alive.
Hope you will find this information helpful!
I remain at your disposal in case of further questions whenever you need!
Kind regards,
Dr. Ilir Sharka, Cardiologist
I would explain as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that if a person has some cardiac activity on the resting ECG he should be resuscitated immediately.
In fact, you should know that manual measurements are not really sensitive when coming to a critically ill patient, compared to ECG machine.
When we do not feel the carotid artery, (and the blood pressure machine shows no pulse), means the blood pressure is less than 60mm Hg. This means that the person is not dead, but he has a too low blood pressure (hypovolemic shock) which can not be registered manually.
The same issue is for the breathing. We usually put our hand on the patient chest to see if it is moving or listen to his breathing. But, in critical ill patients, the breathing may be too weak to be felt.
The same is for the heart rate. Sometimes, we can put our ear on the patients chest (for example : in a road emergency when we do not have any stethoscope, or at home) and the heart beats are too weak to be heard.
For this reason, even when we don't feel the pulse or blood pressure manually, we should try to resuscitate the patient.
So, a resting ECG is a very important tool to evaluate these patients in the ER.
Only when the ECG monitor shows not heart rhythm for a prolonged time, death is confirmed. In such case, other signs of brain death should be evaluated too (pupil size and reaction to the light, oculo-cephalic reflex,, oculo-vestibular reflex, etc..) in order to confirm death.
In case of a drug overdose, the heart rate is too low and the respiration is too weak, so the ECG evaluation is very important.
Even the blood oxygen saturation monitor is not an accurate tool, as it does not show the oxygen saturation when the blood pressure is too low, because there is peripheral vessel constriction in the extremities and it will show no values, although the patient is still alive.
Hope you will find this information helpful!
I remain at your disposal in case of further questions whenever you need!
Kind regards,
Dr. Ilir Sharka, Cardiologist
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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