When Should CPR Terminate? - In a Heartbeat

When Should CPR Terminate?

There is a wealth of information regarding proper CPR administration and AED use for cardiac arrest victims.  However, we are yet to adopt a hard and fast rule regarding how long CPR should be continued on a cardiac arrest victim, or even determine if such a rule would ultimately be beneficial to patients, families and doctors, alike.

Traditionally, the generally accepted practice for “adequate CPR effort” was proposed to be 20 mins in length, by the National Association of EMS Physicians.  The American Heart Association has historically chosen not to make a recommendation, due to limited data on the subject.  

In an effort to formulate a standard for terminating CPR, a Canadian research team was able to predict when CPR would be futile with 99.5 percent accuracy, in 2006.  The successful findings utilized several factors including, no return of spontaneous circulation, no delivery of electric shock and event not witnessed by emergency personnel.

Despite the reported, astounding accuracy of their developed rule, it has not yet been adopted as a formal guideline by the medical community.

With a number of explanations, the most compelling is the possible controversy that may arise from patients, doctors and families, when life saving efforts are ceased based on a guideline versus doctors’ best judgement on the individual situation.  By nature, when analyzing the CPR process, there can be a perception that there’s always more that can be done to give a patient a chance at life. 

While the medical community debates this topic, there is no question regarding the length of by-stander CPR intervention, which should always continue until emergency help arrives.  For every minute that passes, a person’s chance of survival decreases by 10% without CPR intervention.  Conventional CPR should be performed using chest compressions and mouth-to-mouth breathing at a ratio of 30:2 compressions-to-breaths. In adult victims compressions should occur at a rate of 100 to 120/min and to a depth of at least 2 inches.  Untrained bystanders should perform Hands-Only CPR.  

If you are interested in CPR/AED certification or would like to renew your certification, please contact us through our site at https://inaheartbeatllc.com/classes/.



Morrison M.D., L., Visentin B.Sc., B., Kiss Ph.D., Alex, Theriault, R., Eby M.D., D., Vermeulen B.Sc.N, M., Sherbino M.D., J., Verbeek M.D., R. “Validation of a Rule for Termination of Resuscitation in Out-of-Hospital Cardiac Arrest”, https://www.nejm.org/doi/full/10.1056/NEJMoa052620

Parikh, R., “This is why doctors hate to stop CPR even when they know it’s time”, https://www.washingtonpost.com/national/health-science/this-is-why-doctors-hate-to-stop-cpr-even-when-they-know-its-time/2017/02/23/d6557e74-d9bf-11e6-9a36-1d296534b31e_story.html

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