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termination of cardiopulmonary resuscitation (CPR)
Indications:
1) 25-30 minutes from the start of a witnessed cardiac arrest
2) 10 minutes of documented asystole after appropriate implementation of ACLS protocols
3) better outcomes with 25 minutes (mean) of resuscitation vs 16 minutes (mean) [3]
4) Universal Termination of Resuscitation
- resuscitation should be terminated by emergency medical services (EMS) if, after at least 4 2-minute intervals of cardiopulmonary resuscitation, 3 criteria are met:
- the arrest was not witnessed by EMS
- there has been no return of spontaneous circulation
- no shocks were delivered
General
cardiopulmonary resuscitation (CPR)
References
- ACLS - The Reference Texbook
ACLS: Principles & Practice, Cummins RO et al (eds),
American Heart Association, 2003 ISBN 0-87493-341-2
- Wampler DA et al.
Cardiac arrest survival is rare without prehospital return
of spontaneous circulation.
Prehosp Emerg Care 2012 Jul 26
PMID: 22834854
http://informahealthcare.com/doi/abs/10.3109/10903127.2012.695435
- Goldberger ZD et al
Duration of resuscitation efforts and survival after
in-hospital cardiac arrest: an observational study
The Lancet, Early Online Publication, 5 September 2012
PMID: 22958912
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60862-9/fulltext
- Nolan JP and Soar J
Duration of in-hospital resuscitation: when to call time?
The Lancet, Early Online Publication, 5 September 2012
PMID: 22958913
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61182-9/fulltext
- Jordan MR, O'Keefe MF, Weiss D et al.
Implementation of the universal BLS termination of
resuscitation rule in a rural EMS system.
Resuscitation. 2017 Jul 13;118:75-81
PMID: 28713042
http://www.resuscitationjournal.com/article/S0300-9572(17)30285-X/fulltext