Cardiac arrest in the Emergency Medical Service System: guidelines for resuscitation

Abstract

A two-year study of 198 consecutive patients treated for cardiac arrest in the emergency department at Stanford University Medical Center was undertaken. The relatively poor overall survival rate of 3% and the complexity of deciding how to treat cardiac arrest victims suggest the need for guidelines to assist the emergency physician when resuscitating cardiac arrest patients. From the above study and a survey of the literature, the authors formulated the following guidelines of when resuscitation should be discontinued or not attempted: Cases of apnea and pulselessness known to have exceeded 10 minutes, no response after more than 30 minutes of advanced cardiac life support (ACLS), no ventricular EKG activity after more than 10 minutes of ACLS, and preexisting terminal illness.