Cardiac arrest in the emergency medical service system: Guidelines for resuscitation

Eliastam, Michael; Duralde, Thomas; Martinez, Fred; Schwartz, Deborah A.

doi:10.1016/s0361-1124(77)80422-x

Cited by 44 publications

(10 citation statements)

References 14 publications

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“…[2][3][4][5] These all propose that the absence of a ventricular dysrhythmia along with adequate rescue attempts (intubation, defibrillation, IV medications, chest compression) are grounds for discontinuing active resuscitation. Eliastam 2 states that there should have been no response after more than 30 minutes of ALS whereas Smith and Bodai 5 propose that this should be extended to 45 minutes.…”

Section: Discussionmentioning

confidence: 99%

Recognition of death and termination of cardiac resuscitation attempts by UK ambulance personnel

Lockey

2002

Emergency Medicine Journal

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Objectives: To identify whether the practice of the UK ambulance trusts comply with national recommendations with respect to when ambulance personnel are allowed to recognise death and/or terminate resuscitation attempts in the adult, normothermic, non-traumatic cardiac arrest. Methods: Questionnaire study of 39 ambulance trusts. Results: At the time of the study (summer 2000), 23 trusts operated separate policies for recognition of death and termination of resuscitation, two had policies for recognition of death alone, two had policies for termination of resuscitation alone, five operated a policy purely for termination of resuscitation attempts after a limited period of CPR, and seven had no protocols other than "the presence of rigor mortis, postmortem staining or injuries incompatible with life". Only eight trusts conformed to the protocols for both recognition of death and termination of resuscitation attempts recommended by the Joint Royal Colleges Ambulance Liaison Committee (JRCALC). Conclusion:The JRCALC has proposed guidelines for recognition of death and terminating resuscitation attempts in the adult normothermic non-traumatic cardiac arrest. Despite this, there was still considerable variance in the practice of the UK ambulance trusts. I t has been traditional in the United Kingdom (UK) for ambulance personnel to commence resuscitative measures on most normothermic adult cardiac arrest victims. The exceptions have been those patients who have rigor mortis, postmortem staining, or injuries incompatible with life. The Joint Royal Colleges Ambulance Liaison Committee (JRCALC) published guidelines 1 for recognition of death and termination of resuscitation attempts by ambulance service personnel in 1996 (fig 1 and 2). Shortly after the conclusion of this study, they published updated guidelines. The purpose of this survey was to see whether there was unanimity in the approach to the cardiac arrest victim by ambulance personnel from the various UK Ambulance trusts when compared with the nationally recommended guidelines in place at that time. METHODSThirty nine ambulance trusts were identified using the "Directory of Emergency and Special Care Units". The training managers for each trust were contacted by post and asked what policies, if any, existed in their trust for "recognition of death" and termination of resuscitation attempts in the adult, normothermic, non-traumatic cardiorespiratory arrest victim. A follow up letter was sent three months later to those trusts that had not replied. RESULTSThirty five trusts replied to the first letter and the remaining four trusts replied to the follow up letter. The results of the questionnaire are summarised in table 1.• Seven trusts had no policy for termination of resuscitation attempts and would only allow their personnel to recognise death in the presence of irreversible factors (rigor mortis, postmortem staining, or injuries incompatible with life).• Two trusts had a policy purely for termination of resuscitation.• Two trusts had a policy purely for recogn...

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Section: Discussionmentioning

confidence: 99%

Recognition of death and termination of cardiac resuscitation attempts by UK ambulance personnel

Lockey

2002

Emergency Medicine Journal

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“…1 This article contains a fascinating discussion of the conflicting values inherent in an emergency physician's decision whether to attempt resuscitation: ''heroic measures'' expected by society vs. ''death with dignity'' expected by individuals, as well as ''preserving life'' vs. ''avoiding iatrogenic suffering'' expected by the medical community. Using this framework, the authors suggest that resuscitation may not be indicated for every cardiac arrest case, and after examining 198 cardiac arrest patients, a set of recommendations was made for withholding or discontinuing treatment.…”

Section: Whither the Fourth Link?mentioning

confidence: 99%

Whither the Fourth Link?

Cone

2002

Academic Emergency Medicine

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“…There is little uniformity in reporting those variables known to be associated with successful resuscitation, including 1) stratification by etiology, 2) whether the cardiac arrest event was witnessed or unwitnessed, 3) presence of ventricular fibrillation,' [5][6][7][8][9][10][11][12][13][14][15][16][17] and intervals from collapse to cardiopulmonary resuscitation (CPR) and definitive care. [7][8][9] This paper will first discuss the methods and outcome data of major studies reporting emergency resuscitation for out-of-hospital cardiac arrest and review the variety of definitions, methodologies, and reporting methods.…”

Section: Introductionmentioning

confidence: 99%

Out-of-hospital cardiac arrest: a review of major studies and a proposed uniform reporting system.

1980

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Cardiac arrest in the emergency medical service system: Guidelines for resuscitation

Cited by 44 publications

References 14 publications

Recognition of death and termination of cardiac resuscitation attempts by UK ambulance personnel

Recognition of death and termination of cardiac resuscitation attempts by UK ambulance personnel

Whither the Fourth Link?

Out-of-hospital cardiac arrest: a review of major studies and a proposed uniform reporting system.

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