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Medical: 5

Cardiology: 2 ════════════════════════════════════════════════════════════════════════════════════ ══════════════════════════

    • 4.

      Circulation

      • a.

        CPR in conjunction with defibrillation

      • b.

        IV therapy

      • c.

        Defibrillation

      • d.

        Pharmacological

        • (1)

          Gases (oxygen)

        • (2)

          Sympathetic

        • (3)

          Anticholinergic

        • (4)

          Antiarrhythmic

        • (5)

          Vasopressor

        • (6)

          Alkalinizing agents

        • (7)

          Parasympatholytic

    • 5.

      Rapid transport

    • 6.

      Support and communications strategies

      • a.

        Explanation for patient, family, significant others

      • b.

        Communications and transfer of data to the physician

  • E.

    Termination of resuscitation

    • 1.

      Inclusion criteria (for example)

      • a.

        18 years old or older

      • b.

        Arrest is presumed cardiac in origin and not associated with a condition potentially responsive to hospital treatment (for example - hypothermia, drug overdose, toxicologic exposure, etc.)

      • c.

        Endotracheal intubation has been successfully accomplished and maintained

      • d.

        Standard advanced cardiac life support (ACLS) measures have been applied throughout the resuscitative effort

      • e.

        On-scene ALS resuscitation efforts have been sustained for 25 minutes or the patient remains in asystole through four rounds of appropriate ALS drugs

      • f.

        Patient has a cardiac rhythm of asystole or agonal rhythm at the time the decision to terminate is made and this rhythm persists until the arrest is actually terminated

      • g.

        Victims of blunt trauma in arrest whose presenting rhythm is asystole, or who develop asystole while on scene

    • 2.

      Exclusion criteria - for example

      • a.

        Under the age of 18 years

      • b.

        Etiology for which specific in-hospital treatment may be beneficial

      • c.

        Persistent or recurrent ventricular tachycardia or fibrillation

      • d.

        Transient return of pulse

      • e.

        Signs of neurological viability

      • f.

        Arrest was witnessed by EMS personnel

      • g.

        Family or responsible party opposed to termination

    • 3.

      Criteria NOT to be considered as inclusionary or exclusionary

      • a.

        Patient age - for example, geriatric

      • b.

        Time of collapse prior to EMS arrival

      • c.

        Presence of a non-official do-not-resuscitate (DNR) order

      • d.

        "Quality of life" valuations

    • 4.

      Procedures (according to local protocol)

      • a.

        Direct communication with on-line medical direction

        • (1)

          Medical condition of the patient

        • (2)

          Known etiologic factors

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────────────────────────── United States Department of Transportation National Highway Traffic Safety Administration Paramedic: National Standard Curriculum

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