Prehospital Care Manual online - Contra Costa Health Services

CONSIDER
TERMINATION OF
RESUSCITATION
Patients who have all of the following criteria are highly unlikely to survive:
• Unwitnessed Arrest and
• No bystander CPR and
• No shockable rhythm seen and no shocks delivered during resuscitation and
• No return of spontaneous circulation (ROSC) during resuscitation
Patients with asystole or PEA whose arrests are witnessed and/or who have
had bystander CPR administered have a slightly higher likelihood of survival.
If unresponsive to interventions these patients should be considered for
termination of resuscitation.
Key Treatment Considerations
• Atropine is no longer used in cardiac arrest
• Pre-existing acidosis or hyperkalemia should be suspected in patients with renal failure or dialysis or
if suspected diabetic ketoacidosis
• In clear-cut traumatic arrest situations, epinephrine is not indicated in PEA or asystole. If any doubt
as to cause of arrest, treat as a non-traumatic arrest (e.g. solo motor vehicle accident at low speed in
older patients).