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Termination of Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest
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To the Editor: As authors of the article that was the subject of the Editorial by Drs Sanders and Kern,1 we disagree with their assertion that clinical rules for terminating treatment have a way of becoming a self-fulfilling prophecy. All patients in cardiac arrest (excluding those with an advanced directive or obvious signs of death) deserve an adequate attempt at resuscitation using the best available techniques and strategies. Nothing in our study should be construed as proposing that patients should receive anything less. However, when determined efforts at resuscitation fail to re-establish a pulse on the scene—as is frequently the case—it appears that nothing is gained by rushing the patient to the hospital for further efforts at resuscitation.
Concerns have been raised about whether the practice of allowing paramedics to cease efforts in the out-of-hospital setting may undermine their efforts to achieve successful resuscitations. The converse may be true. Encouraging . . . [Full Text of this Article]
Comilla Sasson, MD, MS
comilla@umich.edu
University of Michigan
Ann Arbor
Arthur L. Kellermann, MD, MPH;
Bryan F. McNally, MD, MPH
Emory University
Atlanta, Georgia
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