Abstract
The National Association of EMS Physicians (NAEMSP) believes that emergency medical services (EMS) providers should be able to utilize evidence-guided methodology for the termination of resuscitation in nontraumatic cardiopulmonary arrest. This is the official position of the NAEMSP. Key words: termination of resuscitation; cardiopulmonary arrest; nontraumatic; EMS; position statement; NAEMSP
The National Association of EMS Physicians believes that:
Emergency medical services (EMS) systems should have written protocols that allow for termination of resuscitation (TOR) by EMS providers for patients in nontraumatic cardiopulmonary arrest.
TOR may be considered when, at the time of decision of termination, all of the following conditions have been met:
The arrest was not witnessed by an EMS provider.
There is no shockable rhythm identified by an automated external defibrillator (AED) or other electronic monitor.
There is no return of spontaneous circulation prior to EMS transport.
Further research is needed to determine the following:
The appropriate duration of resuscitation before EMS providers decide that return of spontaneous circulation will not be achieved prior to EMS transport.
The benefit of direct (online) medical oversight in TOR protocols.
EMS systems that have TOR protocols should ensure that the following additional considerations are addressed:
Appropriate management of the deceased patient in the field.
Adequate support services for the patient's family.
TOR protocols should involve active physician oversight.
There are specific clinical, environmental, and population-based situations in which TOR rules may not apply.