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Why is this Important?
- It is a poor stewardship of resources to continue a resuscitation when the prognosis is clearly dismal.
- Hospitals need to steward their resources to distribute equitable care between its patients
When is it Appropriate to Stop CPR on a Pulseless Patient?
- Patient shows signs of irreversible death
- Rigor mortis
- Patient has dismal prognosis (3 studies discuss this)
- Implementation of the universal BLS termination of resuscitation rule in a rural EMS system
- Non-EMS witnessed arrest
- No return of spontaneous circulation prior to transport
- Only non-shockable rhythms present
- Early identification of patients with out-of-hospital cardiac arrest with no chance of survival and consideration for organ donation
- Non-EM witnessed arrest
- Non-shockable INITIAL rhythm
- No ROSC despite 3 doses of epinepherine
- Duration of pre-hospital CPR and favorable neurologic outcomes for pediatric out-of-hospital cardiac arrests. A nationwide, population based cohort study
- Less than 1% chance of recovery after 46 minutes of resuscitation
- Jordan MR, O’keefe MF, Weiss D, Cubberley CW, Maclean CD, Wolfson DL. Implementation of the universal BLS termination of resuscitation rule in a rural EMS system. Resuscitation. 2017;118:75-81.
- Jabre P, Bougouin W, Dumas F, et al. Early Identification of Patients With Out-of-Hospital Cardiac Arrest With No Chance of Survival and Consideration for Organ Donation. Ann Intern Med. 2016;165(11):770-778.
- Goto Y, Funada A, Goto Y. Duration of Prehospital Cardiopulmonary Resuscitation and Favorable Neurological Outcomes for Pediatric Out-of-Hospital Cardiac Arrests: A Nationwide, Population-Based Cohort Study. Circulation. 2016;134(25):2046-2059.