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Resuscitation in OHCA: When to START and When to STOP ,[object Object],[object Object],[object Object]
Goals of Resuscitation  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Ethical Issues ,[object Object],[object Object]
Healthcare Advance Directive ,[object Object],[object Object],[object Object],[object Object]
Do Not Attempt Resuscitation (DNAR) order ,[object Object],[object Object],[object Object],[object Object]
พรบ .  สุขภาพแห่งชาติ พ . ศ .  ๒๕๕๐ ,[object Object]
 
Withholding & Withdrawing CPR in OHCA ,[object Object],[object Object],[object Object],[object Object]
Criteria for Not Starting CPR (OHCA) ,[object Object],[object Object],[object Object],[object Object]
DNAR Orders in OHCA ,[object Object],[object Object]
Advance Directives in OHCA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Termination of Resuscitation (TOR) in OHCA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
When to STOP BLS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BLS Termination of Resuscitation Rule for Adult OHCA ,[object Object],[object Object],[object Object],[object Object],Morrison LJ, et al. Validation of a rule for termination of resuscitation in out-of-hospital cardiac arrest. N Engl J Med. 2006;355: 478-487.
[object Object],Use the rule to develop protocols in areas where ALS is not available or may be significantly delayed (Class I, LOE A).
When to STOP ALS ,[object Object],[object Object],[object Object]
ALS Termination of Resuscitation Rule for Adult OHCA ,[object Object],[object Object],[object Object],[object Object],[object Object],Morrison LJ, et al. Derivation and evaluation of a termination of resuscitation clinical prediction rule for advanced life support providers. Resuscitation. 2007;74: 266.275.
It is reasonable to employ this rule in all ALS services (Class IIa, LOE B). ,[object Object]
TOR in a Combined BLS and ALS Out-of-Hospital System ,[object Object],[object Object]
Implementation of the Rules ,[object Object],[object Object],[object Object],[object Object]
 
When to Start/Stop CPR ? ,[object Object],[object Object],[object Object]
General Rule ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
Organ Procurement ,[object Object],[object Object]
Traumatic Cardiopulmonary Arrest (TCPA)
[object Object]
Blunt Trauma ,[object Object],[object Object],[object Object],[object Object]
Penetrating Trauma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Penetrating or Blunt Trauma ,[object Object],[object Object],[object Object]
Nontraumatic Cause of Arrest ? ,[object Object],[object Object]
Termination of Resuscitation (TOR) ,[object Object],[object Object],[object Object]
Special Consideration  ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
… Still Controversy
[object Object],[object Object],[object Object],J Trauma. 2005;5:951-958 .
[object Object],[object Object],[object Object],[object Object],[object Object],Injury, Int. J. Care Injured (2006) 37, 448—454
[object Object],[object Object],[object Object],[object Object],Ann Emerg Med. 2006;48:240-244.
[object Object]
THANK YOU

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Resuscitaion in ohca