Decision to Carry Out or Termination of Resuscitation in Prehospital Setting

摘要

Emergency physicians are being increasingly confronted with patients with cardiac arrest; in individual cases, the question arises as to whether cardio-pulmonary resuscitation should be started or if the resuscitation process already initiated should be terminated. There are guidelines and statements from the ERC and the Federal Chamber of Physicians as well as references in the literature. However, since there are no binding predictors for this question, beside the initial situation noted in history taking, the decision must be taken on an individual basis and not on the basis of rigid time constraints. Particular attention should be paid to the special features of resuscitation in polytrauma, hypothermia, pulmonary embolism and suicide. Elderly patients also represent a specific group of patients in whom, for example, a "dummy" resuscitation is performed. In the decision to carry out and terminate resuscitation, the patient's wish has also to be consulted if this is recognizable on the spot. Reasons for omission of resuscitation in the preclinical area are summarized.