Update 1990 pp 632-642 | Cite as

When to Stop CPR?

  • M. Gauthier
  • J. Lacroix
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 10)

Abstract

Basic life support techniques (BLS) and more advanced therapies for emergency treatment and stabilization of patients in the postarrest phase (ACLS) are well known to emergency physicians and intensivists. The medicolegal considerations of resuscitation, namely the obligation to provide, and the indications for withholding or withdrawing cardiopulmonary resuscitation (CPR) [1] are less familiar to most health care providers.

Keywords

Depression Ischemia Pneumonia Bicarbonate Epinephrine 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    1985 National Conference on Cardiopulmonary Resuscitation and Emergency Cardiac Care (1986) Standards and Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care. Part VIII: Medicolegal considerations and recommendations. JAMA 255:2979–2984CrossRefGoogle Scholar
  2. 2.
    Eliastam M, Duralde T, Martinez F, Schwartz D (1977) Cardiac arrest in the emergency medical service system: guidelines for resuscitation. JACEP 6:525–529PubMedCrossRefGoogle Scholar
  3. 3.
    Thompson RG, Hallstrom AP, Cobb LA (1979) Bystander-initiated cardiopulmonary resuscitation in the management of ventricular fibrillation. Ann Intern Med 90:737–740PubMedGoogle Scholar
  4. 4.
    Cummins RO, Eisenberg MS, Hallstrom AP, Litwin PE (1985) Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation. Am J Emerg Med 3:114–118PubMedCrossRefGoogle Scholar
  5. 5.
    Roth R, Stewart RD, Rogers K, Cannon GM (1984) Out-of-hospital cardiac arrest: factors associated with survival. Ann Emerg Med 13:237–243PubMedCrossRefGoogle Scholar
  6. 6.
    Stueven H, Troiano P, Thompson B, et al (1986) Bystander/first responder CPR: ten years experience in a paramedic system. Ann Emerg Med 15:707–710PubMedCrossRefGoogle Scholar
  7. 7.
    Rozenbaum EA, Shenkmann L (1988) Predicting outcome of in-hospital cardiopulmonary resuscitation. Crit Care Med 16:583–586PubMedCrossRefGoogle Scholar
  8. 8.
    Nichols DG, Kettrick RG, Swedlow DB, Lee S, Passman R, Ludwig S (1986) Factors influencing outcome of cardiopulmonary resuscitation in children. Pediatr Emerg Care 2:1–5PubMedCrossRefGoogle Scholar
  9. 9.
    Ludwig S, Kettrick RG, Parker M (1983) Pediatric cardiopulmonary resuscitation. A review of 130 cases. Clin Pediatr 23:71–75CrossRefGoogle Scholar
  10. 10.
    DeBard ML (1981) Cardiopulmonary resuscitation: analysis of six years’ experience and review of the literature. Ann Emerg Med 10:408–416CrossRefGoogle Scholar
  11. 11.
    Woog RH, Torzillo PJ (1987) In-hospital cardiopulmonary resuscitation: prospective survey of management and outcome. Anaesth Intens Care 15:193–198Google Scholar
  12. 12.
    Eisenberg M, Bergner L, Hallstrom (1983) Epidemiology of cardiac arrest and resuscitation in children. Ann Emerg Med 12:672–674Google Scholar
  13. 13.
    Torphy DE, Minter MG, Thompson BM (1984) Cardiorespiratory arrest and resuscitation in children. Am J Dis Child 138:1099–1102PubMedGoogle Scholar
  14. 14.
    Wark H, Overton JH (1984) A pediatric “cardiac arrest” survey. Br J Anaesth 56:1271–1274PubMedCrossRefGoogle Scholar
  15. 15.
    Gillis J, Dickson D, Rieder M, Steward D, Edmonds J (1986) Results of inpatient pediatric resuscitation. Crit Care Med 14:469–471PubMedCrossRefGoogle Scholar
  16. 16.
    Zaritsky A, Nadkarni V, Getson P, Kuehl K (1987) CPR in children. Ann Emerg Med 16:1107–1111PubMedCrossRefGoogle Scholar
  17. 17.
    Longstreth WT, Inui TS, Cobb LA, Copass MK (1983) Neurologic recovery after out-of-hospital cardiac arrest. Ann Intern Med 98 (Part 1) 588–592PubMedGoogle Scholar
  18. 18.
    Rockswold G, Sharma B, Ruiz E, Asinger R, Hodges M, Brieter M (1979) Follow up of 514 consecutive patients with cardiopulmonary arrest outside the hospital. JACEP 8:216–220PubMedCrossRefGoogle Scholar
  19. 19.
    Losek JD, Hennes H, Glaeser P, Hendley G, Nelson DB (1987) Prehospital care of the pulseless, nonbreathing pediatric patient. Am J Emerg Med 5:370–374PubMedCrossRefGoogle Scholar
  20. 20.
    Messert B, Quaglieri CE (1976) Cardiopulmonary resuscitation. Perspectives and problems. Lancet 2:410–411PubMedCrossRefGoogle Scholar
  21. 21.
    Bedell SE, Delbanco TL, Cook EF, Epstein FH (1983) Survival after cardiopulmonary resuscitation in the hospital. N Engl J Med 309:569–576PubMedCrossRefGoogle Scholar
  22. 22.
    Lewis JK, Minter MG, Eshelman SJ, Witte MK (1983) Outcome of pediatric resuscitation. Ann Emerg Med 12:297–299PubMedCrossRefGoogle Scholar
  23. 23.
    Davies CR, Carrigan T, Wright JA, Ahmann PA, Watson C (1987) Neurologic outcome following pediatric resuscitation. J Neurosci Nurs 19:205–210PubMedCrossRefGoogle Scholar
  24. 24.
    Lund I, Skulberg A (1976) Cardiopulmonary resuscitation by lay people. Lancet 2:702–704PubMedCrossRefGoogle Scholar
  25. 25.
    Tweed WA, Bristow G, Donen N (1980) Resuscitation from cardiac arrest: assessment of a system providing only basic life support outside of hospital. Can Med Assoc J 122:297–300PubMedGoogle Scholar
  26. 26.
    Gudjonsson H, Baldvinsson E, Oddsson G, et al (1982) Results of attempted cardiopulmonary resuscitation of patients dying suddenly outside the hospital in Reykjavik and the surrounding area, 1976–1979. Acta Med Scand 212:247–251PubMedCrossRefGoogle Scholar
  27. 27.
    Vertesi L, Wilson L, Glick N (1983) Cardiac arrest: comparison of paramedic and conventional ambulance services. Can Med Assoc J 128:809–813PubMedGoogle Scholar
  28. 28.
    Guzy PM, Pearce ML, Greenfield S (1983) The survival benefit of bystander cardiopulmonary resuscitation in a paramedic served metropolitan area. Am J Public Health 73:766–769PubMedCrossRefGoogle Scholar
  29. 29.
    Peatfield RC, Sillet RW, Taylor D, McNicol MW (1977) Survival after cardiac arrests in hospital. Lancet 1:1223–1225PubMedCrossRefGoogle Scholar
  30. 30.
    Weinberg M, Thomassen A (1979) Prognosis after cardiac arrest occurring outside intensive care and coronary units. Acta Anesthesiol Scand 23:69–77CrossRefGoogle Scholar
  31. 31.
    Bickell WH, Rice MM, Dellinger RP (1988) Termination of resuscitation. In: Civetta JM, Taylor RW, Kirby RR (eds) Critical care. Lippincott Co, Philadelphia, pp 121–124Google Scholar
  32. 32.
    Brain Resuscitation clinical trial I Study group (1985) Neurologic recovery after cardiac arrest: Effect of duration of ischemia. Crit Care Med 13:930–931CrossRefGoogle Scholar
  33. 33.
    Chipman C, Adelman R, Sexton G (1981) Criteria for cessation of CPR in the emergency room. Ann Emerg Med 10:11–17PubMedCrossRefGoogle Scholar
  34. 34.
    Kellermann AL, Staves DR, Hackmann BB (1988) In-hospital resuscitation following unsuccessful prehospital advanced cardiac life support: “Heroic efforts” or an exercise in futility? Ann Emerg Med 17:589–594PubMedCrossRefGoogle Scholar
  35. 35.
    Safar P (1989) Cardiopulmonary cerebral resuscitation. In: Shoemaker WC, Ayres S, Grenvik A, Holbrook PR, Thompson WL (eds) Textbook of critical care, 2nd edn. WB Saunders CO, Philadelphia, pp 5–40Google Scholar
  36. 36.
    Smith JP, Bodai B (1985) Guidelines for discontinuing prehospital CPR in the emergency department A review. Ann Emerg Med 14:1093–1098PubMedCrossRefGoogle Scholar
  37. 37.
    Castagna J, Weil MH, Shubin H (1974) Factors determining survival in patients with cardiac arrest. Chest 65:527–529PubMedCrossRefGoogle Scholar
  38. 38.
    Myerburg RJ, Conde CA, Sung RJ, et al (1980) Clinical, electrophysiologic and hemodynamic profile of patients resuscitated from prehospital cardiac arrest. Am J Med 68:568–576Google Scholar
  39. 39.
    Montgomery WH (1986) The 1985 conference on standards and guidelines for cardiopulmonary resuscitation and emergency care. JAMA 255:2990–2991PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • M. Gauthier
  • J. Lacroix

There are no affiliations available

Personalised recommendations