title: Termination of resuscitation of nontraumatic cardiopulmonary arrest: resource document for the National Association of EMS Physicians position statement.
abstract: In the development of an emergency medical services (EMS) system, medical directors should consider the implementation of protocols for the termination of resuscitation (TOR) of nontraumatic cardiopulmonary arrest. Such protocols have the potential to decrease unnecessary use of warning lights and sirens and save valuable public health resources. Termination-of-resuscitation protocols for nontraumatic cardiopulmonary arrest should be based on the determination that an EMS provider did not witness the arrest, there is no shockable rhythm identified, and there is no return of spontaneous circulation (ROSC) prior to EMS transport. Further research is needed to determine the need for direct medical oversight in TOR protocols and the duration of resuscitation prior to EMS providers' determining that ROSC will not be achieved. This paper is the resource document to the National Association of EMS Physicians position statement on the termination of resuscitation for nontraumatic cardiopulmonary arrest.
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21209, USA. millin@jhmi.edu
authors.forename: Michael G
authors.initials: MG
authors.lastname: Millin
authors.forename: Samiur R
authors.initials: SR
authors.lastname: Khandker
authors.forename: Alisa
authors.initials: A
authors.lastname: Malki
mesh_terms: D001291:Attitude of Health Personnel; D002985:Clinical Protocols; D003657:Decision Making; D004632:Emergency Medical Services / Q000592:standards*; D019317:Evidence-Based Medicine; D019983:Guideline Adherence / Q000706:statistics & numerical data; D017408:Guidelines as Topic; D019538:Health Care Surveys; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D018447:Medical Futility; D012151:Resuscitation / Q000592:standards*; D009927:Tissue and Organ Procurement / Q000379:methods / Q000592:standards; D028761:Withholding Treatment / Q000592:standards*