Field termination of resuscitation: analysis of a newly implemented protocol

Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors
Elizabeth O'BrienD C Cone

Abstract

Earlier work has shown the safety of termination-of-resuscitation (TOR) protocols for traumatic and nontraumatic out-of-hospital cardiac arrest (OOHCA). This study examined the implementation of these protocols in one urban/suburban EMS system. The objective was to determine how often patients are transported to the ED despite meeting TOR criteria. All adult OOHCA patients transported to two EDs during a 3.5-year interval were retrospectively identified through dispatch and hospital records. EMS and ED records were evaluated to assess for the presence of TOR protocol criteria and to determine whether the patients should have been transported or pronounced dead on scene. Records were also examined for documentation of mitigating circumstances that might have prompted transport despite meeting TOR criteria. 865 OOHCA patients were identified; 235 met study criteria. Of these, 131 (56%) met TOR criteria but were transported anyway. All expired in the ED or in the hospital (131/131 = 100%, 95% CI: 97.7-100) Of the 43 traumatic OOHCA patients, 27 (63%) met TOR criteria, yet were transported, and all expired in the ED (27/27 = 100%, 95% CI: 89.5-100). Of the 192 nontraumatic OOHCA patients, 104 (54%) met TOR criteria, yet were transp...Continue Reading

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Citations

Jul 21, 2010·Journal of General Internal Medicine·Ezra GabbayDavid M Kent
Oct 15, 2013·Critical Care : the Official Journal of the Critical Care Forum·Yoshikazu GotoYumiko Nakatsu Goto
Mar 25, 2014·Annals of Emergency Medicine·Mary E FallatMary E Fallat
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Apr 14, 2016·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Randy Wang Long CheongMarcus Eng Hock Ong
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