WildlandEMT89
Forum Lieutenant
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We would of worked it until we had clearance to terminate given the circumstances you provided.
Field Termination of Resuscitation GuidelinesRevised and Approved by AEMS Board of Governors – July 19, 2006
Purpose: The purpose of this document is to provide a guideline for on-line medical control physicians to aid in the process of termination of resuscitation in the pre-hospital setting. In order to stop or withhold resuscitation efforts, an order from an on-line medical control physician is required. This document is not meant to establish a standard of care or mandate a specific action in individual cases of cardiac arrest.
Medical Indications:
1. Cardiac arrest is not associated with a condition that would easily respond to in-hospital treatment.
2. Airway has been managed appropriately.
3. ACLS measures have been followed during the resuscitation effort, including 3doses of appropriate medications.
4. The patient is in asystole or an agonal rhythm at the time the order is given tostop resuscitation.
Documentation of this event should be complete and include rhythm strips. Family or medical power of attorney requests for continued resuscitation efforts should be honored.
Trauma Indications:
1. Blunt trauma patient who is found to be apneic, pulseless, and in asystole.
2. Penetrating trauma patient who is found to be apneic, pulseless and in asystoleand without other signs of life such as pupillary reflexes or spontaneousmovement.
3. Resuscitation efforts may be withheld if a trauma patient meets the criteria in theabove #1 & #2.
On-line medical direction should be established as soon aspossible to confirm the decision to withhold resuscitation efforts.
In multiple patient situations, there may be inadequate resources to devote care to the resuscitation of pulseless patients. In such cases, the highest trained provider on the scene should confirm that the patient is pulseless and direct care to more viable patients. In addition, if the patient is pulseless and extrication is necessary before CPR can be provided, the patient should be triaged as deceased.
Obvious Death Criteria:
1. Decapitation/Decomposition
2. Dependent Lividity/Rigor Mortis
If the patient meets any of the criteria above, no resuscitative efforts are required. On- line medical direction is NOT required.
Other Considerations: It is recommended that termination of resuscitation be done on scene. If it is done during transport, the body may not be accepted at any hospital. Contact the police dept. or sheriff’s office for disposition of the body. Consider on-scene grief support for family members. A “Prehospital Medical Care Directive” (orange DNR form) can be accepted as a “Do Not Resuscitate” order if it is complete.
It's also of note that we utilize CCR before getting into ACLS
Field Termination of Resuscitation GuidelinesRevised and Approved by AEMS Board of Governors – July 19, 2006
Purpose: The purpose of this document is to provide a guideline for on-line medical control physicians to aid in the process of termination of resuscitation in the pre-hospital setting. In order to stop or withhold resuscitation efforts, an order from an on-line medical control physician is required. This document is not meant to establish a standard of care or mandate a specific action in individual cases of cardiac arrest.
Medical Indications:
1. Cardiac arrest is not associated with a condition that would easily respond to in-hospital treatment.
2. Airway has been managed appropriately.
3. ACLS measures have been followed during the resuscitation effort, including 3doses of appropriate medications.
4. The patient is in asystole or an agonal rhythm at the time the order is given tostop resuscitation.
Documentation of this event should be complete and include rhythm strips. Family or medical power of attorney requests for continued resuscitation efforts should be honored.
Trauma Indications:
1. Blunt trauma patient who is found to be apneic, pulseless, and in asystole.
2. Penetrating trauma patient who is found to be apneic, pulseless and in asystoleand without other signs of life such as pupillary reflexes or spontaneousmovement.
3. Resuscitation efforts may be withheld if a trauma patient meets the criteria in theabove #1 & #2.
On-line medical direction should be established as soon aspossible to confirm the decision to withhold resuscitation efforts.
In multiple patient situations, there may be inadequate resources to devote care to the resuscitation of pulseless patients. In such cases, the highest trained provider on the scene should confirm that the patient is pulseless and direct care to more viable patients. In addition, if the patient is pulseless and extrication is necessary before CPR can be provided, the patient should be triaged as deceased.
Obvious Death Criteria:
1. Decapitation/Decomposition
2. Dependent Lividity/Rigor Mortis
If the patient meets any of the criteria above, no resuscitative efforts are required. On- line medical direction is NOT required.
Other Considerations: It is recommended that termination of resuscitation be done on scene. If it is done during transport, the body may not be accepted at any hospital. Contact the police dept. or sheriff’s office for disposition of the body. Consider on-scene grief support for family members. A “Prehospital Medical Care Directive” (orange DNR form) can be accepted as a “Do Not Resuscitate” order if it is complete.
It's also of note that we utilize CCR before getting into ACLS
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