Criteria for Death/Witholding Resuscitation
- CPR and ALS treatment are to be withheld only if the patient is obviously dead or a valid South Carolina Do Not Resuscitate form is present (see DNR Protocol).
- To honor those who have obviously expired prior to EMS arrival.
BLS Providers (EMS or Fire)
If a patient is in complete cardiopulmonary arrest (clinically dead) and meets one or more of the criteria below, CPR and ALS therapy need not be initiated:
- Valid DNR (refer to policy 1.5)
- Body decomposition.
- Rigor mortis.
- Injury not compatible with life (i.e., decapitation, burned beyond recognition, massive open or penetrating trauma to the head or chest with obvious organ destruction).
- If a bystander, first responder has initiated CPR or automated defibrillation prior to BLS arrival and any of the above criteria (signs of obvious death) are present, the BLS provider may discontinue CPR.
ALS Providers (EMS or Fire)
In addition to the above criteria, CPR and ALS therapy need not be initiated if the following are present:
- Traumatic arrest in asystole or PEA < 30.
- Extended downtime (20 or more minutes of no CPR) or un-witnessed arrest with asystole on the EKG in two leads.
- If a bystander, first responder, or BLS provider has initiated CPR or automated defibrillation prior to ALS arrival and any of the above criteria (signs of obvious death) are present, the ALS provider may discontinue CPR.
- If doubt exists, start resuscitation immediately. Once resuscitation is initiated, continue resuscitation efforts until either:
- Resuscitation efforts meet the criteria for implementing the Discontinuation of PreHospital Resuscitation Policy.
- Patient care responsibilities are transfered to the destination hospital staff
- Order to terminate resuscitation are received by Medical Control