The LA Story: What Happened After a New Policy Allowing Paramedics to Forgo Resuscitation Attempts in Prehospital Cardiac Arrest
Grudzen, Corita R
Hoffman, Jerome R
Koenig, William J
Lorenz, Karl A
Asch, Steven M
Resuscitation 2010 Jun; 81(6): 685-90
BACKGROUND: Despite potential harm to patients, families, and emergency personnel, a low survival rate, and high costs and intensity of care, attempting resuscitation after prehospital cardiac arrest is the norm, unless there are signs of irreversible death or the presence of a valid, state-issued DNR. OBJECTIVE: To determine whether there was a change in the rate of forgoing resuscitation attempts in prehospital cardiac arrest after implementation of a new policy allowing paramedics to forgo resuscitation based on a verbal family request or the presence of certain arrest characteristics. METHODS AND RESULTS: All prehospital run sheets for cardiac arrest in Los Angeles County were reviewed for the first seven days of each month August 2006-January 2007 (pre-policy) and January-June 2008 (post-policy). Paramedics were more likely to forgo resuscitation attempts after the policy change (13.3% vs. 8.5%, p
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Grudzen, Corita R; Koenig, William J; Hoffman, Jerome R; Boscardin, W John; Lorenz, Karl A; Asch, Steven M (2009-04)Forgoing resuscitation in prehospital cardiac arrest has previously required a written prehospital do-not-resuscitate (DNR) order. Some emergency medical services (EMS) agencies, including Los Angeles County (LAC), have ...