Withholding or Ceasing Resuscitation

Question 1

When to Withhold Resuscitation:

Answer 1

10 DID RIP:

• > 10/60 downtime, in asystole with no compelling reasons to commence
• declared dead
• injuries incompatible with life
• DNR in place (>18y with RoTC for existing condition or <18y with emergency management plan signed by doctor and parent/guardian)
• risk to paramedic or bystander safety
• inadequate resources for all patients
• prolonged cardiac arrest

Question 2

Compelling Reasons for Resuscitation:

Answer 2

H O C Fa Sol:

• hypothermia
• overdose
• child
• family request
• signs of life present

Question 3

When to Cease Resuscitation:

Answer 3

• no hypothermia
• no overdose
• adult >18 years
• no signs of life
• not in shockable rhythm (VF or VT)
• following 30-45/60 resuscitation including drug therapy

Question 4

Verification of Death Criteria:

Answer 4

5-10/60 following cessation/withholding of resuscitation:

• no palpable pulse
• 30sec printed ECG strip showing asystole
• fixed, dilated pupils
• no response to centralised stimulus
• no response to nail bed pressure
• no heart sounds for 2/60
• no breath sounds for 2/60