The decision making will depend on a number of factors.
• The environment of the cardiac arrest and access to emergency medical services.
• The interval between cardiac arrest and commencement of basic life support (BLS).
• The interval between BLS and advanced life support (ALS).
• Evidence of cardiac death (asystole).
• Potential prognosis and co-morbidity (Ambery et al. 2000).
• Age of the casualty, but this is a controversial issue (Larkin 2002).
• Temperature: hypothermia offers a degree of protection and efforts, prolonged if necessary, should be made to warm the patient (see Chapter 11).
• Drug intake prior to cardiac arrest.
• Remediable precipitating factors (Resuscitation Council UK 2000a).
Resuscitation should continue if there is any evidence of cardiac electrical activity and should only cease if asystole is present. It has been recommended that patients should be monitored for ten minutes after resuscitation efforts have stopped (Maleck et al. 1998). The final decision rests with the team leader, though it should be made in consultation with the cardiac arrest team (Gabbott et al. 2000).
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