Cardiopulmonary resuscitation at the pre-hospital period: criteria of terminating resuscitation (a clinical case analysis)

The clinical case analysis revealed the pressing need for enhanced emergency medical services, in particular, regarding the adequate performance of cardiopulmonary resuscitation in the pre-hospital setting. The analysis is focused on reasonable decision to terminate cardiopulmonary resuscitation. It is revealed that there are significant conflicts in the algorithms, protocols, clinical recommendations and the decree of the Government of the Russian Federation on determining the moment to terminate cardiopulmonary resuscitation with lasting pulseless electrical activity. The conflicting requirements create problems in practical activity of emergency medical services teams, build grounds for expert claims and make an important issue for a comprehensive study. The discussed subject seems to be highly relevant: in case of out-of-hospital deaths, emergency medical services are the only life-saving facility.