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CPR Clean Pretty Reliable
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alt title(s): Clean Pretty Reliable Cardiopulmonary resuscitation (CPR) is an emergency first aid protocol for an unconscious person on whom both breathing and pulse cannot be detected. In the simplest terms, the person using it alternates between breathing into the recipient's mouth, which forces some oxygen into their lungs, then rhythmically pushing against the ribs and the heart underneath, to help circulate their blood. This serves to keep the body and brain alive a bit longer than they would have without assistance. Ideally, it's performed by two people, one to do the breathing and the other to do the compressing, but one person can alternate tasks if there's nobody else to help.
In TV-land, it's:
- Clean (doesn't take into account hygiene, oral-vector diseases, or any precautions against these.)
- Pretty (it's heroic to know how to do CPR; unless the show is a Sit Com or an anime series, hold the Ho Yay! or anxiety for the perception of same. It also gives a reason for a male character to undo a female one's blouse- or vice versa)
- Reliable (unless the story calls for the character to be Killed Off For Real or Ascend To A Higher Plane Of Existence, he'll be back in action, no muss, no fuss. If the character is destined to die, his rescuers will give up the situation as hopeless within just a few minutes.) In fact, a 1996 study published in the New England Journal of Medicine showed that CPR success rates in television shows was 75%.
In reality, CPR alone does not "bring anyone back", it simply preserves the body for defibrillation and advanced life support. Few patients will make a complete recovery, and those that do survive often develop serious complications. If CPR is begun within several minutes of cardiac arrest and defibrillation arrives shortly thereafter, a patient's chances of recovery rise to approximately 80%. CPR alone is successful only 2-4% of the time. If CPR is initiated more than 10 minutes after arrest then survival drops to less than 10% with full ACLS intervention. Because of this low survival rate, in disaster situations where timely advanced medical care is unlikely or impossible, rescue workers will not perform CPR at all, instead moving on to treat victims with higher probabilities of survival.
One of the essential rules of CPR is that you never just quit. You keep up the process until either proper help arrives, the victim revives on their own, or you physically can't continue the exertion. Of course, several minutes of CPR is boring to watch, so TV characters will frequently make a token effort, then decide that it's hopeless and give up. A more ridiculous variation is when one person is performing CPR while another checks the victim's pulse and then sorrowfully tells the would-be hero that it's no good, because A.) The second person could have been helping, and B.) The whole point of CPR is to substitute for the victim's breathing and heartbeat. If he had a pulse, he wouldn't need CPR in the first place.
CPR also tends to involve breaking a rib or two during the compression stage. Most doctors agree that the rib cage needs to be damaged to allow for the heart to be compressed properly. Also, an inexperienced CPR administrator is prone to place his hands too far down on the sternum, breaking off the sharp-ended Xiphoid Process and puncturing or even destroying the heart. This never seems to come up.
Additionally, most CPR patients' first involuntary reaction on achieving resuscitation is to vomit. Far from pretty, and we won't even go into clean. (Whats worse is alot of times they throw up when they are dead! The jerks. Well... they don't throw up, the process of ventilation and pumping their chest forces air into the stomach and then it comes out one end or another)
Many CPR-certified people purchase and carry face masks to minimize the chance of catching an infection from administering CPR. Nearly all medical professionals who actually expect to have to do CPR will have one—most EMTs will carry one, for instance, and lifeguards nowadays are supposed to have them in their lifeguarding kits. However, there have been no cases of diseases being transmitted via CPR in the last 30 years in the U.S. (Despite this, most people who expect to do CPR, especially EMTs, will still prefer a bag-valve mask instead of a breather in order to maintain better body substance isolation protocols.) In many states pocket face masks aren't even standard issue, you have to get your own as the state and local REMSCO (rightly) supposes that you would rather let someone die than kiss a corpse, even indirectly.
TV, however, universally dispenses with this device, even when the person giving CPR is an EMT, even when they're doing it to a complete stranger who may well have a horrible disease, even when they aren't specifically going for the metaphorical associations of the Kiss Of Life. Probably because use of those masks is far from universal — a lot of people who get their CPR certification reasonably don't actually expect to do CPR anytime soon and don't carry them around, and so if you're unlucky enough to see someone need CPR in an emergency situation you probably won't see a mask being used, and CPR masks therefore remain unfamiliar and jarring in the few situations where you do see them being used.
In real life, not all CPR includes rescue breathing. Some studies have shown that in the case of heart attack victims, CPR without rescue breathing - called "hands-only CPR" - can actually save more lives than CPR with rescue breathing, especially if the person administering the CPR is not a health care professional.
Newer Than You Think, too, as the technique didn't really come about until the 1960s. Older works will feature things like "Silvester's Method".
If the "victim" is faking in order to get the rescuer to lip lock, it's the Kiss Of Life. (Its also unwise- see 'broken Xiphoid process accidentally destroying heart' above.)
Examples:
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Anime and Manga
- The first episode of Mai-HiME, though the victim does spit up water and presumably had only stopped breathing because of water inhalation.
- The first episode of FLCL.
- Vision Of Escaflowne - Millerna and Van very much perform the Kiss Of Life version on Hitomi. Though it's more realistic in some respects - Hitomi doesn't quite vomit, but she comes close to coughing her guts out and looks half dead for a few minutes.
- Subverted in Monster: It's obviously a wasted, desperate effort and the dude obviously stays dead.
- Spoofed in Full Metal Panic? Fumoffu. After fishing Sousuke out of the school's pool, Tesse insists on giving him CPR. Sure, that makes sense — Except for one thing: he's already breathing. Of course, seeing as Tesse's mostly just trying to take advantage of the situation for some good ol' lip-locking, the students' attempts to point this out don't deter her very much.
- When Haru is unconcious after his fight with Lance (in Rave Master) the older Musica proposes artificial respiration to try and revive him. Elie volunteers and is just about to put her lips on his when he wakes up. Haru greets her cheerfully. He gets slugged.
Literature
- Subverted in Angels And Demons. When the second preferiti is found, the main characters attempt to give CPR in a realistic fashion, with one providing breath and the other getting ready to do compressions. However, the attempt is anything but clean; the preferiti has two holes in his lungs, causing blood to spray out and into the face of the poor guy standing over him. Needless to say, he doesn't survive.
- It is also tried again unsuccessfully, with the final kidnapped victim who was drowned in a fountain. This troper seems to recall mention that Landon performed CPR for quite some time before realizing it was useless.
- Subverted in Earthly Delights by Kerry Greenwood. When the heroine finds a junkie who overdosed on her grate and gave her CPR, she placed plastic wrap over the junkie's mouth (and put a fairly large hole in it for the air) so she wouldn't catch anything.
- Averted in Johnny And The Bomb as Yo-less briefly considers performing CPR on Mrs. Tachyon but the gang decides to just call an ambulance instead for hygiene reasons.
- In Jim Butcher's Dresden Files novel Storm Front, Morgan having rescued Harry from the burning building, Harry comes to finding him performing CPR.
- Done in Thieves Like Us, when the Big Bad accidentally shoots the ancient mummy-like leader of an ancient cult attempts to perform CPR to revive him. It doesn't work and there is mention that his nose is pulled off when she grips it (yes, that's how hold he is). Possibly justified in that she was probably panicked having just mortally injured the ancient and greatly beloved leader of an extremely pissed cult who was surrounding her and proceeded to kill her when their leader dies.
Comic Books
- In an arc of The Avengers called "Red Zone", Captain America is exposed to a contagious evil bacteria and stops breathing. Saying, "Sorry Tony... but Captain America's more important than you", Iron Man immediately takes off his helmet and starts mouth-to-mouth. (With dramatic lighting and close-ups!) The "CPR revives people by itself" aspect is theoretically averted, as his goal is to keep Cap alive until he can be rescued, but ultimately used straight as, minutes later, Iron Man is passed out and Cap is weak and disoriented, but on his feet. Must be the Super Soldier Serum.
- In the first volume of Runaways Gert uses CPR on Chase after he's been submerged in water and stops breathing. He feels pretty crappy immediately afterwards, but recovers pretty quickly.
- In an X-Files comic, Scully performs CPR on a man in cardiac arrest. In a minor subversion, the comic actually points out the need to break the ribs to properly massage the heart, but just CPR is still enough to stabilize him.
Film
- Used in the first Jurassic Park, after Tim was electrocuted by the fence Dr. Grant spent a few moments trying to bring him back, which works so well Tim finished his last sentence. Though they did make some token gestures indicating that he was not completely fine, such as burnt hands, bleeding ears and a limp for the rest of the movie.
- The Abyss
- Averted in Casino Royale, mainly because it doesn't work and Vesper dies anyway.
- In the recent Nancy Drew movie, Nancy performs CPR on someone who is pretending to choke.
- Heavily, heavily averted in The Orphanage - the woman being recusitated didn't make it, and brief glimpse to her face shows that her entire lower jaw was horribly dislocated by the car that hit her, showing that the guy giving CPR had really strong stomach, though being a trained doctor probably helped.
- Star Trek VI: The Undiscovered Country has Dr. McCoy attempting to revive a Klingon who has been shot in the chest. His heart isn't beating, so McCoy tries CPR for a few seconds and then gives it the two-fisted Kirk punch, which brings him back to life long enough to utter appropriate final words. However, in some rare cases, a physical jolt to the heart like that can indeed take it out of fibrillation.
Live Action TV
- Every Medical Drama.
- One aversion was in an episode of ER, where a drunk and passed out partygoer vomits into the mouth of Noah Wylie's character when he tries to administer CPR.
- Also, a notable early episode had Noah Wyle's character giving CPR to an elderly gentlemen while nurses prepared to defibrillate. Noah Wyle then proceeds to break the old man's rib with a loud crack.
- Totally averted in Casualty 1909, which is set before CPR was invented.
- In the "Prophecy Girl" episode of Buffy The Vampire Slayer, Xander revives Buffy with CPR and she recovers fully and quickly. Buffy, of course, is a Slayer with supernatural healing ability, which makes it more acceptable. A more realistic depiction is in the episode "The Body" — Buffy attempts CPR on her mom and breaks a rib, which is common even without Slayer strength. This is also a rare case of it failing (although it's also one where it would be incredibly ridiculous for it to succeed, given that the cause of death was a brain aneurysm). Buffy's not even sure if her mother is alive at this point.
- She's not...the body is cold, and aneurysms generally kills in very short order. The chances of survival are extremely low without immediate (as in, you're already in the ICU) surgery to stop the bleeding.
- In Xena Warrior Princess, Xena accidentally invents CPR to save Gabrielle's life after a seizure (caused by a head injury) apparently kills her. ("She just needs air. I need to get some air into her lungs!" and, later, sobbing and pounding on her chest as she demands that her friend "Wake up! Wake up! Wake up!") Being her love int—er, sidekick, Gabs does.
- Partially subverted in that, although the newly-resuscitated Gabrielle doesn't vomit, she is white as a sheet, sweaty, trembling, staring, thoroughly disoriented, and looks as though she would very much like to spew her guts.
- MacGyver, episode "The Enemy Within": MacGyver and a friend apply CPR to the victim of an induced heart attack, demonstrating technique that would make a first aid teacher fail them on the spot, and keeping at it only long enough to show they tried before giving up and saying "He's dead" in a suitably dramatic voice. Later in the same episode, there's also a dodgy scene involving a defibrillator.
- Nearly every episode of Baywatch included a swimmer drowning or near-drowning in the ocean, only to be pulled out by a lifeguard and given CPR for a few harrowing seconds before coughing up some water and being as good as new.
- Averted in some episodes especially in the first 2 seasons (before Pamela Anderson) when CPR is used just to stabilize the victim until defibrillator arrives or is ready. Especially in rescues involving the Scarabs. In one S1 episode there is even a mention when one of the characters is rescued by an amateur lifeguard only to have breathing problems later that night, that every rescue by a professional lifeguard is finished at the hospital, where the victim is checked.
- This trope was almost averted in the first season of Lost, when guitarist Charlie Pace is hung from a tree while attempting to rescue fellow survivor Claire. When he is found by Jack Sheppard (a doctor) and Kate Austen, Jack tries CPR on him for three minutes, but it doesn't seem to work. The music plays very somberly, and it looks like he is dead for good... until Jack starts yelling at him to wake up, and keeps pounding his chest until Charlie comes to. So close.
- Exactly the same thing happens in Mission Impossible 3.
- Lost is infamous for its (mis)use of medicinal techniques. CPR is used in almost every life and/or death scenario. Medicine works much better than it has any right to on the show. The very worst 'medical moment' was the very first death on the show: Boone dies after falling off a cliff while trapped inside a plane, although it doesn't happen all in one shot: we get a whole episode devoted to his death of blood loss/infection which the aformentioned doctor combats by jury-rigging an I.V. tube out of plastic hosing and two sea urchin needles.
- Several of this incidents are implicitly or explicitly due to the island's Green Rocks properties; in particular, the hanging scene went out of its way to show that Jack was insane to assume he could do anything about Charlie, to the point where he was basically just punching him in the chest near the end.
- Also used on Punky Brewster, in an episode called "Cherie Life Saver".
- Episodes of both Law And Order and CSI New York have had HIV-transmission scares from giving artificial respiration, so yay for recognizing that stuff can be transmitted. Even better, both series also note that it's vastly unlikely for HIV to go through saliva.
- Averted in Criminal Minds wherein a character attempts CPR on his subordinates, but only succeeds in breaking their ribs, and is later taunted with the true statistics of CPR.
- But it's played straight in a later episode, where it's used to revive a young girl who's been without air for something like seven minutes. She gets up and walks home with her parents.
- Doctor Who, "Smith and Jones". Especially as The Doctor's problem required a blood transfusion, not CPR.
- Also done when Martha finds Jack unconscious outside of the TARDIS. In fact, she performs CPR on him each time he "dies" (usually of gunshot wounds) until The Doctor figures out he's immortal and tells her not to bother.
- In (the American version of) Eleventh Hour, a show about a scientist using science to combat pseudoscientific practices, said scientist brings a person back to life using CPR, heart monitor spiking and all.
- In Law And Order SVU, one episode has main character Elliot Stabler rough up a suspect when trying to arrest him. The subject then collapses and, after a few seconds of checking for a pulse, Stabler starts CPR. Said CPR is performed for approximately 20 seconds before his partner, standing 5 feet away and not bothering to help, exclaims, "He's dead...", at which point Stabler gives up.
- The X-Files put a paranormal take on CPR - in the episode 'Oubliette', Mulder tries to save a drowned girl but his CPR seems futile. But because the girl has a strange physical-psychic transference link to another person, she suddenly revives while her 'partner' is found dead, literally drowned despite sitting in a police car nearby. Funnily enough the girl was played by a then-teenage Jewel Staite (who you might remember from a show that's quite popular on this wiki), who reportedly didn't mind being 'revived' by David Duchovny.
- But there's another episode (i don't remember the title) wherein Scully, the MD, declares that someone has a heartbeat but isn't breathing, and then begins chest compressions.
- In an an episode of Corner Gas, Hank tries to prove a random dog is in fact The Littlest Hobo by faking a heart attack (or something). Unfortunately for him, a fireman notices, and rushes in trying to perform CPR.
- When Denny has a heart attack in season five of Boston Legal, everyone thinks he's faking until Alan realises he's not breathing and leaps in to save him. Slightly more realistic than usual, as an ambulance is called and we don't see Denny conscious again until he's on his way to the hospital.
- In 24 Season 2, Jack saves Nina by giving her a few mouth breathes, without fixating her chest or using any compression at all. It works.
- Partly subverted in Family Matters of all shows, when Urkel saves an electrocuted Carl with CPR, he remembers to get a CPR mask out of Carl's first aid kit, preventing any mouth contact. Only partly subverted in that sense, as in a few moments Carl is fine and dandy.
- Partly subverted in the season four episode "Breath of Life" for The District. Sergeant Brander performs CPR on another officer, using it the proper way to keep the victim going long enough for an ambulance, after the victim's partner refused to do it because the victim is gay. Brander not using a mouth guard makes for a minor bit of suspense, as he waits for test results about whether he caught anything from the victim.
- Eureka depicted it as a semi-romantic kiss involving no chest compressions. Partially subverted in that it was just used to keep the victim stable until medical help could arrive.
Machinima
- In Red Vs Blue Grif somehow uses CPR to save Sarge from a sniper round to the head, and they were both wearing helmets the entire time. Doc later tells him that was the best thing to do (FYI, he's not a very good medic).
- Lampshaded when Sarge, annoyed at having to admit Grif did something right and incredulous at his methodology (which he praised Simmons for until corrected), asks, "What would you have done if I'd gotten shot in the foot? Rubbed aloe vera on my neck?!" Further lampshaded when Caboose gets shot in the foot, and Doc responds predictably.
Video Games
- Played straight in the Xbox Live Arcade game Castle Crashers, as other players can practically instantly revive a defeated ally by pumping on their chest. Probably an Acceptable Break From Reality, and considering the game's atmosphere... not so unexpected. Though since they could already cast magic in it, it makes you wonder why they didn't just use White Magic.
- Probably because all of the magic is offensive save for the King's.
- Played completely straight in the Sierra game Codename: IceMan. In the opening area, a girl swims out to sea, and promptly needs saving. The following procedure has to be done according to the handbook that came [[Feelies with the game]], otherwise the girl dies, and well you lose puzzle points..
- Final Fantasy VII had Cloud, who had not been trained, perform mouth-to-mouth on a nine-year-old girl.
- Video game example: In the Grand Theft Auto series, NPCs who are beaten up or shot to death can be CPR'ed by paramedics who arrive at the scene. The poor victim will then get up and be back to full health, after which you can beat him up again. Rinse, repeat. Heck, repeatedly killing gangsters in this manner can be used in San Andreas to start a turf war in sparsely-populated territory.
- In Yahtzee's retro adventure game Trilby's Notes, the titular character is revived via CPR after a fatal stab wound. The sequel reveals that he was really revived by gaining the life force from a future clone.
- In Indigo Prophecy, you can at one point drag a small boy out of a frozen lake and give him CPR. You can easily lose the segment if you're not fast enough, and doing so nets you a game over.
- The Continue screen for the arcade beat-'em-up The Punisher (and Nick Fury) shows your character receiving CPR. Of course, the only true salvation in this scenario is the quarter in your pocket.
- In Metal Gear Solid 4 Johnny Gave Meryl CPR after she drowned. She did spit up water after that but she was revived.
Western Animation
- This used with some justification in the Gargoyles episode "Hunter's Moon," where one gargoyle, Angela, is seriously wounded and the clan's human ally Elisa performs CPR. Here, the point is not to revive her, but to keep her alive just long enough for the sun to rise which makes all the gargoyles enter their stone state that instantly heals even mortal injuries. Thus when the sun sets again, Angela awakens fully healed.
- Perhaps the cleanest, prettiest, and most reliable version of CPR shown on TV was in one episode of American Dad, where Roger passes out after choking on an unspecified foodstuff. Steve, who had become impromptu certified in CPR the previous day, immediately jumps to his side without even thinking about checking for a pulse or other vital signs, claiming "I know CPR!" before bringing him back from a potentially fatal situation with two breaths and no use of chest compression whatsoever. Don't even get me started on how he neglected to think of the Heimlich maneuver...
- Of course, knowing who writes that show, that might entirely be the point.
- The lack of a Heimlich seemed more like a plot device, given that Steve becomes pregnant because he came in contact with an alien "seed" after giving him CPR. Yeah...
- X-Men, the 90s Animated Series: When Cyclops passes out after a couple seconds' exposure to toxic gasses, Rogue gives him CPR to return him to normal and it never comes up again. (However, she gains his uncontrollable Eye Beams from the Kiss Of Life.) This is especially silly since Rogue's power, in addition to giving her the abilities of the person she touches, also sucks "life force", which you'd think someone far enough gone to need CPR wouldn't really have to spare.
- Subverted humorously in the episode of SpongeBob SquarePants where a large flounder attempts to beat him for no reason in particular. When the flounder suffers a medical crisis, he wakes up in a hospital to learn that his life was saved when SpongeBob performed CPR on him for six and a half hours straight. Regardless, the understanding is that EMS was responsible for his ultimate resurrection.
Spongebob: They said you were fine after the first three minutes, but I just wanted to make sure.
- Hilariously parodied on Family Guy when Chivalrous Pervert Glenn Quagmire (during a test to see if some therapy to make him non-perverted worked) suddenly loses control and runs into the security room in a clothing store. There he takes notice of a woman having a heart attack in the changing room. He darts out of the security room and runs to her body and begins what appears to be CPR. However when the woman wakes up, everybody in the store cheers Quagmire for saving her life. Quagmire's response:
Quagmire: What the hell's CPR?
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