Do Termination of Resuscitation Guidelines Predict Cardiac Arrest Survival?

The Research Drennan I, Case E, Verbeek P, et al. A comparison of the Universal TOR Guideline to the absence of prehospital ROSC and duration of resuscitation in predicting futility from out-of-hospital cardiac arrest. Resuscitation. 2017;111:96-102. The Science The authors wanted to determine how well the Universal Termination of Resuscitation (TOR) Guideline could predict survival from cardiac arrest. The TOR recommends that resuscitation be terminated in the field when all three of the following are true: 1) EMS didn't witness the arrest; 2) return of spontaneous circulation (ROSC) didn't occur despite resuscitation attempts; and 3) the patient was never defibrillated. Specifically, the authors wanted to discover the survival rate of patients who were transported solely based on failing to obtain ROSC. Data were extracted from the Resuscitation Outcomes Consoritum PRIMED database, which was created to study the effect of an impedance threshold device (ITD) and/or immediate vs. delayed defibrillation. Between 2007 and 2011 there were 36,543 cases of cardiac arrest. Of these, 9,467 (26%) were transported without ROSC. Patients without ROSC for whom the TOR recommend termination at the scene had a survival rate of 0.7% compared to 3.0% of patients for whom the TOR recommended transport. The authors concluded that transporting cardiac arrest patients based solely on the absence of ROSC isn't appropriate and encourage EMS agencies to utilize the TOR fully to identify the best c...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Columns Source Type: news