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. 2021 Sep 16;29:138. doi: 10.1186/s13049-021-00946-7
Quantitative result Witnessed cardiac arrest 74% Bystander BLS 60% Defibrillation 44% Mean end-tidal carbon dioxide value 2.3 kPa Mean duration of resuscitation 54 min Multiple factors reported when ceasing resuscitation Variation in the rationales to cease resuscitation SCA involvement in 6% of patients who died at the scene
Qualitative questions 1. How do witnessed cardiac arrest influence a cessation decision? 2. How does bystander resuscitation influence a cessation decision? 3. How do rhythm changes influence a cessation decision? 4. What are your views on end-tidal values when ceasing resuscitation? 5. Is there a duration of resuscitation beyond which you would cease resuscitation? 6. Which factors influence your resuscitation decisions the most? 7. Why was there variation in the rationales to cease resuscitation? 8. What are your thoughts on SCA support and remote decisions?
Qualitative findings "Witnessed is more likely to be known, a longer period and obviously the worst outcome." (SCA2) “It does make impact on a decision to cease, but there is no way of knowing if that was effective.” (SCA2) “A rhythm change to asystole is a poor, but any other rhythm changes is a positive.” (SCA1) “If they’ve been reasonable and deteriorated then again, I’m going to want the whole bigger picture.” (SCA3) “I think it depends the different factors, anything over 45 min I’m a bit cenacle about.” (SCA5) “The rate of the PEA the morphology is really relevant.” (SCA1) “It’s a difficult subjective in hindsight it’s easy when you are look at the resus unfolding in front of you.” (SCA5) “They are difficult I reflect on my decision and feel a sense of loss for the family.” (SCA6)
Qualitative themes Defining a futile resuscitation The impact of ceasing resuscitation Supportive tools for cessation of resuscitation decisions Perceived conflict between the senior and on-scene paramedic
Summary and interpretation of results PEA in a local context
SCA experiences of ceasing resuscitation
Multifactorial decision-making