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Article
March 9, 1994

Out-of-Hospital CPR-Reply

Author Affiliations

Emory University Atlanta, Ga
University of Tennessee Memphis, Tenn

JAMA. 1994;271(10):748-749. doi:10.1001/jama.1994.03510340037028
Abstract

In Reply.  —Timely provision of prehospital emergency cardiac care results in optimal rates of survival from cardiac arrest.1 If prehospital ACLS fails to achieve return of spontaneous circulation, repeating these efforts in a hospital offers little or no benefit. Given the costs and risks of rapid transport, policies that mandate this practice should be abandoned.2Any decision to terminate ACLS in the field must be authorized by an on-line EMS physician. We agree with Dr Jolly that in-service training must also be provided to help paramedics deal with the family's grief. Several EMS services already have policies that permit termination of unsuccessful ACLS in the field.3 They have not reported significant problems.If our guidelines had been followed, the circumstances Dr Lipkis describes would not have led to the premature termination of efforts to save her father. We believe that every patient who sustains a cardiac arrest

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