Inter-rater reliability and comfort in the application of a basic life support termination of resuscitation clinical prediction rule for out of hospital cardiac arrest

Morrison, Laurie J.; Visentin, Laura; Vermeulen, Marian J.; Kiss, Alex; Theriault, Robert; Eby, Don; Sherbino, Jonathan; Verbeek, P. Richard

doi:10.1016/j.resuscitation.2006.10.030

Cited by 13 publications

(8 citation statements)

References 29 publications

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“…A series of articles by Morrison et al validating the termination of resuscitation rule estimated that the frequency of out-of-hospital adult cardiac arrest transports to the ED could be reduced from 100% to 37.4% of calls, with no loss of viable patients, thus resulting in valuable resource and cost savings. [91][92][93] In addition to the cost concerns, the "lights and siren" run is associated with significant potential for injury to EMS personnel and the public. [94][95][96][97] Finally, the costs of supplies (often including precious blood products) and the emotional toll on ED providers who would not otherwise be exposed to the death, including the risk of posttraumatic stress disorder, are all important considerations that should not be ignored when choosing whether to transport a patient who is already dead or who will inevitably die (unpublished survey data; in process to submit for publication).…”

Section: Discussionmentioning

confidence: 99%

Withholding or Termination of Resuscitation in Pediatric Out-of-Hospital Traumatic Cardiopulmonary Arrest

Fallat¹,

Cooper²,

Salomone³

et al. 2014

Pediatrics

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This multiorganizational literature review was undertaken to provide an evidence base for determining whether recommendations for outof-hospital termination of resuscitation could be made for children who are victims of traumatic cardiopulmonary arrest. Although there is increasing acceptance of out-of-hospital termination of resuscitation for adult traumatic cardiopulmonary arrest when there is no expectation of a good outcome, children are routinely excluded from state termination-of-resuscitation protocols. The decision to withhold resuscitative efforts in a child under specific circumstances (decapitation or dependent lividity, rigor mortis, etc) is reasonable. If there is any doubt as to the circumstances or timing of the traumatic cardiopulmonary arrest, under the current status of limiting termination of resuscitation in the field to persons older than 18 years in most states, resuscitation should be initiated and continued until arrival to the appropriate facility. If the patient has arrested, resuscitation has already exceeded 30 minutes, and the nearest facility is more than 30 minutes away, involvement of parents and family of these children in the decision-making process with assistance and guidance from medical professionals should be considered as part of an emphasis on family-centered care because the evidence suggests that either death or a poor outcome is inevitable. Pediatrics 2014;133:e1104-e1116

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Section: Discussionmentioning

confidence: 99%

Withholding or Termination of Resuscitation in Pediatric Out-of-Hospital Traumatic Cardiopulmonary Arrest

Fallat¹,

Cooper²,

Salomone³

et al. 2014

Pediatrics

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show abstract

“…Before the protocol is implemented, EMS providers require training in sensitive communication with the family about the outcome of the resuscitative attempt. 31 This strategy will help to ensure comfort of the provider and appropriate support of the grieving family. Support for the prehospital protocol should be sought from collaborating external agencies (eg, destination hospital emergency departments [EDs], coroner, medical directors, and police) before implementation.…”

Section: Terminating Resuscitative Efforts In a Bls Out-of-hospital Smentioning

confidence: 99%

Part 3: Ethics

Morrison¹,

Kierzek²,

Diekema³

et al. 2010

Circulation

Self Cite

218

161

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“…In a subsequent validation study, paramedics chose to stop resuscitation in 3% of the arrests when BLS-TOR actually called for transport. 5 In 15% of the cardiac arrests, trained paramedics, many of whom had participated in the original BLS-TOR derivation study, expressed discomfort about applying the rule. 5 Reasons cited for disagreement included the patient's age, family distress, or short transport time to the hospital.…”

Section: Yes-bruce D Adamsmentioning

confidence: 99%