General guidelines

Question 1

Define the ages used for resuscitation.

Answer 1

• Adult (> 12yrs)
• Paediatric (≤ 12yrs)
• Newborn (immediately postpartum)

Question 2

What nine (9) circumstances are considered special for resuscitation?

Answer 2

• Asthma/COPD
• Decompression illness
• Hypothermia 
• Morbid obesity 
• Pacemaker/Implantable Cardioverter
  Defibrillator (ICD)
• Paramedic witnessed arrest (of suspected
  cardiac aetiology)
• Pregnancy 
• Tracheostomy 
• Tramatic arrest

Question 3

In what circumstances would it be appropriate to withhold CPR?

Answer 3

• Obvious signs of death

• Decomposition and/or putrefaction
• Hypostasis
• Rigor mortis

• Injuries Incompatible with life
  - Decapitation 
  - Cranial & cerebral destruction 
  - Hemicorporectomy (or similar)
  - Incineration 
  ‐ Foetal maceration

• Endangerment of life, health or safety of officer
• Lawful direction
  • Direction by medical practitioner
  • AHD (sighted)
  • Health attorney or guardian decision
  • ARP / Statement of choices

Question 4

Outline the general discontinuation criteria

Answer 4

• CPR no less than 20min
• Signs of life extinct
  - no carotid pulse
  - no heart sounds 30sec
  - no breath sounds for 30sec
  - fixed, dilated pupils
  - no response to central stimuli 
• Asystole OR PEA rate < 10/min

• Consult if pt in shockable (VF/VT) > 30min

Question 5

Outline the rapid discontinuation criteria

Answer 5

Discontinue/withdraw before 20min:

• Unresponsive & pulseless for at least 10min 
  prior to arrival
• No CPR has been performed 
• Signs of life extinct 
   - no carotid pulse
   - no heart sounds 30sec
   - no breath sounds for 30sec
   - fixed, dilated pupils
   - no response to central stimuli
• Asystole