top of page

Withholding or Ceasing Resuscitation (CPG A0203-1)

hand.png

Stop

  • Do not attempt Mx if risk to safety

  • A patients Advanced Care Directive (ACD) must be followed even where the emergency is not directly related to a pre-existing illness.

​​

tick.png

Mass casualty

  • Refer to SAFR Emergency Response Plan

tick.png

Compelling reason to withold resuscitation

  • ACD to not commence resus
    OR

  • Obvious death

    • Injuries incompatible with life (i.e. massive cranial destruction)

    • Rigor mortis

    • Post mortem lividity

    • Putrefaction/decomposition

    • Death declared by Dr

tick.png

No prospect of resuscitation

  • Asystole (presenting rhythm)
    AND

  • Collapse to CPR delay > 10 mins

tick.png

Discontinuation of resuscitation

  • Non-shockable initial rhythm

    • 15-20 mins of ALS

    • No compelling reason to continue

  • Shockable initial rhythm

    • 45 mins of ALS

    • Cannot be transported with mechanical CPR

    • No other compelling reason to continue

tick.png

Verification of death

  • Confirm determinants of death and consider Verification of Death form

tick.png

Notes

  • Compelling reasons depend on clinical judgement and may include:

    • Signs of life including pupil reaction, agonal or gasping respirations

    • Periods of ROSC

    • Youth and/or the absence of co-morbidities

tick.png

Flow Chart

Withholding Resus Flowchart.jpg
bottom of page