Termination of resuscitation attempts:   

Within resuscitation attempts, there are certain criteria where, despite best efforts, resuscitation will not be successful, or to start would be futile due to the length of time the patient has been in arrest: 

• If following ALS interventions, the patient has been in persistent and continuous asystole for 30 minutes, and all reversible causes have been identified and corrected, resuscitation may be discontinued, except in the following cases – 
• Pregnancy 
• Hypothermic patients 
• Suspected drug overdose 
• Infants, children, and adolescents 
• These patients should be transported to the nearest suitable facility 

Where the patient has been in cardiac arrest for some time, there is no realistic chance of a successful resuscitation if all the following exist together –  

• More than 15 minutes have elapsed since the onset of cardiac arrest 
• There is no evidence of bystander CPR before the arrival of the ambulance 
• All exclusion factors are absent – Drowning, Hypothermia, Poisoning/Overdose, Pregnancy, Child/Neonate 
• Asystole is recorder for more than 30 seconds on the ECG monitoring screen 

As discussed, these are some of the main principles for ROLE within the UK. Some Ambulance Trusts and organisations will have differing criteria and guidelines. It is important to review your local guidelines and act within your scope of practice to provide the best care for the patient. Some of the decisions can be difficult when weighing up various factors and information, and further study should be undertaken to improve your personal knowledge and decision making.