9 Questions
According to the ATCEMS System standard, when should resuscitation, including CPR, be withheld?
When the patient is obviously dead as per specific criteria
Which condition warrants withholding or terminating resuscitation according to the ATCEMS System standard?
Complete exsanguination
In what scenario should resuscitative care not be initiated or continued by an ATCEMS System Provider?
When the patient is pulseless and apneic without any obvious mortal wounds
What does the ATCEMS System standard consider as a valid reason for withholding resuscitative efforts?
Decapitation - complete severing of the head from the body
According to ATCEMS System guidelines, what would prompt a provider to document specific indications for withholding or terminating resuscitation in the ePCR?
If the patient meets any of the specific criteria for withholding or terminating resuscitation
What is the purpose of contacting communications for a time of death?
To confirm the absence of signs of life and pulselessness
Under what conditions can an ALS provider contact communications for a time of death?
Cardiac standstill via ultrasound
When should resuscitative care be discontinued?
At the discretion of the arriving case
Under which circumstances may providers/responders immediately stop resuscitation efforts?
Presence of dependent lividity and rigor mortis
Study Notes
Withholding Resuscitation
- Resuscitation, including CPR, should be withheld if the patient has a valid Do-Not-Resuscitate (DNR) order or has signs of obvious death (i.e., decapitation, decomposition, or rigor mortis).
- A valid reason for withholding resuscitation is if the patient has a terminal illness or injury and has a DNR order or a prehospital DNR form.
Documenting Resuscitation Efforts
- A provider should document specific indications for withholding or terminating resuscitation in the ePCR, such as the patient's condition, advance directives, or a DNR order.
Contacting Communications for a Time of Death
- The purpose of contacting communications for a time of death is to notify them of the patient's demise and provide a time of death.
- An ALS provider can contact communications for a time of death if the patient has obvious signs of death, a valid DNR order, or has been pronounced dead by a physician.
Discontinuing Resuscitation
- Resuscitative care should be discontinued if the patient has a valid DNR order, has signs of obvious death, or if resuscitation efforts are deemed futile.
- Providers/responders may immediately stop resuscitation efforts if the patient has a DNR order, has obvious signs of death, or if the patient's condition is deemed non-survivable.
Test your knowledge on the criteria for withholding resuscitative efforts in the ATCEMS System, including when resuscitation, including CPR, should be withheld and the parameters for determining if a patient is obviously dead or has a valid OOH DNR.
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