Policy 10–Discontinuation of Resuscitation

Who may discontinue unsuccessful CPR/ALS in the field, and what happens after?

An EMS paramedic, if all criteria are met; EMS will not transport the patient once discontinuation has been elected and all criteria are met.

Do you need to contact Medical Control to discontinue resuscitation if all criteria are met?

No — CPR/ALS may be discontinued without contacting Medical Control if ALL criteria are met.

What must all adult family members on scene agree to?

That resuscitation efforts should be stopped; if even one disagrees and wants continuation/transport, EMS should honor that request if safe.

What airway and access requirements must be met to discontinue resuscitation?

Airway successfully managed and verified (ET intubation, King airway, or cricothyrotomy), and IV or IO access achieved.

What CPR quality requirement must be met?

Adequate CPR administered with recorded ETCO2 readings, and rhythm-appropriate medications/defibrillation given per protocol.

What rhythm criteria must be present to discontinue resuscitation?

Persistent asystole or a pulseless agonal rhythm below 20 bpm, with no reversible causes identified, after a minimum of 25 minutes of resuscitation, confirmed in at least two leads and documented.

What must be true about ROSC and defibrillation history to discontinue?

No ROSC was achieved at any point, and if the patient required defibrillation, they must now be in persistent asystole for at least 20 minutes.

Who else must agree before discontinuing resuscitation?

All EMS and first responder personnel involved in the patient's care.

What should you do if any of the discontinuation criteria are NOT met but discontinuation seems indicated?

Contact Medical Control.