How long do you attempt resuscitation for before calling a code?

[blondy2061h, MSN, RN]

Obviously there will be a time range on this question based on a variety of factors- age, circumstances of the code, response to the treatments tried during the code, and the patient's prognosis otherwise, but I'm curious to hear what your experiences have been with this. I've been in a three hour code before, and others where we tried for an hour and people commented that was a long time.

[emtpbill, ASN, RN, EMT-P]

I think your first sentence sums it up, age and circumstances. As a medic it is up to me for when I determine no further resuscitative efforts will be attempted. I look at if it was witnessed arrest or unwitnessed, how long have they been down, and comorbidity factors. If it's a pediatric code that was witnessed I am gonna keep going until I empty the drug box, if it's a 98 yo nursing home patient, while I am going to follow protocol of ACLS, I may call it after three rounds of drugs.

[AnnieOaklyRN, BSN, RN, EMT-P]

Hi,

As you said it all depends on the age, how they died or a presumed cause of the cardiac arrest (if it was trauma we tend to work them for less time since they are not going to come back no matter what you do), and if they are responding to medications and other interventions, and more importantly how long their down time was, especially if it was without CPR. Pupils will also play a factor, if they are fixed and dilated, they are essentially brain dead.

Where I work on the ambulance we work them for 20-25 minutes at home and then call it, but obviously we use our judgement and tools (end tidal CO2, cardiac monitor etc) in every case. I also talk to the family first before termination to get an idea about how they feel about leaving their loved one at home, and surprisingly most of them would rather avoid the hospital if the patient is not responding to ACLS interventions. i do give them the option for either or. Obviously if they have signs that they have been down to long we do not initiate efforts at all.

Hope this helps!

Annie