Review questions: CPR

351. While the general rule is to provide emergency treatment to a victim of cardiac arrest, what are a few exceptions where withholding CPR might be appropriate?

● Situations where attempts to perform CPR would place the rescuer at risk of serious injury or mortal peril

● Obvious clinical signs of irreversible death (eg, rigor mortis, dependent lividity, decapitation, transection, or decomposition)

● A valid, signed, and dated advance directive indicating that resuscitation is not desired, or a valid, signed, and dated DNAR order

352. Once rescuers start BLS, how long should they continue resuscitative efforts?

● Restoration of effective, spontaneous circulation

● Care is transferred to a team providing advanced life support

● The rescuer is unable to continue because of exhaustion, the presence of dangerous environmental hazards, or because continuation of the resuscitative efforts places others in jeopardy

● Reliable and valid criteria indicating irreversible death are met, criteria of obvious death are identified, or criteria for termination of resuscitation are met.

353.  What are the “BLS rules” for termination of resuscitative efforts for adult victims of out-of-hospital cardiac arrest?

All of the following criteria must be present before moving to the ambulance for transport, to consider terminating BLS resuscitative attempts for adult victims of out-of-hospital cardiac arrest: (1) arrest was not witnessed by EMS provider or first responder; (2) no return of spontaneous  circulation (ROSC) after 3 full rounds of CPR and automated external defibrillator (AED) analysis; and (3) no AED shocks were delivered. Implementation of the rule includes real-time contacting of medical control when the rule suggests termination.

354. What are the general “ALS rules” for termination of resuscitative efforts for adult victims of out-of-hospital cardiac arrest?

(1) arrest was not witnessed; (2) no bystander CPR was provided; (3) no ROSC after full ALS care in the field; and (4) no AED shocks were delivered.

355.  What are some are recognized situations where resuscitation may not be indicated in newly born infants?

When gestational age, birth weight, or congenital anomalies are associated with almost certain early death and when unacceptably high morbidity is likely among the rare survivors



Reviewed 2/28/16