Termination of resuscitation: the art of clinical decision making.
Despite all of the progress in reanimating patients in cardiac arrest over the last half century, resuscitation attempts usually fail to restore spontaneous circulation. Thus, the most common of all resuscitation decisions after initiation remains the decision to stop. An entire library of research and guidelines for terminating resuscitative efforts has been developed in the past decade. However, this most central decision is often left open to chance, provider preference, family wishes, futility judgments, and resource concerns-a host of subjective considerations at the bedside and beyond. This article sheds light on these considerations, acknowledging the pivotal role that resuscitation science and guidelines can play in the multifactorial decision to discontinue resuscitative efforts.
Larkin
Gregory Luke
GL
Department of Surgery and Division of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA. Gregory.Larkin@UTSouthwestern.edu
D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D003422:Critical Care / Q000592:standards / Q000639:trends; D003657:Decision Making; D004632:Emergency Medical Services / Q000592:standards / Q000639:trends; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D011788:Quality of Life; D016414:Resuscitation Orders; D012680:Sensitivity and Specificity; D016019:Survival Analysis