C308
- Do not initiate efforts if injuries are incompatible with life, including decapitation, hemicorporectomy, burned beyond recognition, or obvious signs of prolonged death including rigor mortis (in the absence of hypothermia), decomposition, or lividity
- For all others, perform CPR and transport to trauma center. Patients under 18 can be transported to a pediatric trauma center.
- Treat life threatening injuries: control external hemorrhage, decompress chest when appropriate and, when managing BLUNT trauma, initiate fluid resuscitation via IV/IO with normal saline (1L for adults, 20ml/kg for pediatric patients)
- Treat PEA >40 bpm with fluids; treat V-fib/V-tach per cardiac protocol; consider termination of efforts for asystole
Per SB 204, in the setting of hypothermia
- Temperature <30°C or 86°F:
- Continue CPR
- Only administer one round of ACLS drugs
- No more than three defibrillations
- Temperature 30° – 35°C (86° – 95°F):
- Double the interval of time between drug dosing
- Defibrillate normally
Per A105, all EMS personnel may terminate resuscitative efforts
- If resuscitation was started prior to the discovery of an valid DNR as defined in A106, OR
- If, upon further examination, the patient meets the determination of death criteria, including either an injury incompatible with life (i.e. decapitation, or burned beyond recognition) and/or the victim shows signs of rigor mortis (in a warm environment), dependent lividity, or decomposition, OR
- If the following medic conditions below are met
Per A105, medics may terminate resuscitative efforts and not transport patients under active CPR if all of the following exist:
- Good contact between the paramedic unit and the medical control physician
- Successful airway management and medication administration consistent with other protocols in the SW Ohio EMS Protocol
- At least 30 minutes of resuscitative efforts
- NO sustained return of spontaneous circulation at any time (palpable pulse > 60 BPM for at least one five-minute period)
- NO spontaneous respiration, eye opening, motor response, or other neurologic activity at the time stopping resuscitation is contemplated
- The cardiac rhythm is NOT persistent or recurrent VF or VT
- All paramedics and the medical control physician agree with termination of ACLS
- The suspected cause of the cardiac arrest must be something other than hypothermia, electrocution, or lightning strike
It is recommended to transport pregnant patients even if there has been no return of spontaneous circulation, as an unborn fetus may benefit from emergency caesarian-section delivery