EMS A to Z: Termination of Resuscitation

Show Notes:

From your hosts, Dr. Josh Gaither, Dr. Amber Rice, and Dr. Rachel Munn

When can a cardiac arrest be terminated on scene WITHOUT resuscitation or electrical confirmation?

In an apneic and pulseless patient who is:

Decapitated

Decomposed  

Burned beyond recognition  

Has extrusion of brain matter  

Has removal of lower half of body  

In rigor mortis  

Has absent signs of life with a valid DNR order present 

The Dead on Scene Administrative Guideline allows us to terminate resuscitation without medical direction in some instances:

In a MEDICAL cardiac arrest:

If unwitnessed or prolonged downtime & asystole or PEA

If witnessed; after 20 min. of resuscitation, asystole or PEA & ETCO2 < 20

In a TRAUMATIC cardiac arrest:

If blunt trauma & asystole or PEA < 40

If penetrating trauma; asystole or PEA < 40 & > 15 min transport time to trauma center.

Remember your critical cardiac arrest interventions!

Medical arrests: good CPR & early defibrillation

Traumatic arrests: rapid transport if indicated, interventions like needle decompression if indicated