1.  Resuscitation that is started in the field by licensed EMS personnel CANNOT be discontinued without a physician order. Licensed EMS personnel are not obligated to continue resuscitation efforts that have been started by other persons at the scene if the patient meets the criteria listed in the Prehospital Death Determination protocol. This includes telephone CPR initiated by Emergency Medical Dispatchers.

2.  Resuscitation should be terminated/ not initiated if a valid DNR/POLST or physician written order is provided without telemetry contact.

 3.  Resuscitation started in the field may be discontinued only by physician order when the following conditions have been met:

A.  For medical arrest:

The patient remains in persistent asystole or agonal rhythm and has capnography <10 after twenty (20) minutes of appropriate Paramedic/EMT-P resuscitation, to include:
1)  CPR
2)  Effective ventilation with 100% oxygenation
3)  Administration of appropriate ACLS medications

B.  For traumatic arrest:

1)  Open airway with basic life support measures
2)  Provide CPR and effective ventilation with 100% oxygenation for two (2) minutes
3)  Perform bilateral needle thoracentesis if tension pneumothorax suspected
4)  Confirm no organized rhythm or a PEA <40.

C.  The patient develops, or is found to have one of the following conclusive signs of death at any point during the resuscitative effort::

1)  Lividity of any degree
2)  Rigor mortis of any degree

3.  When resuscitation has been terminated in the field, all medical interventions shall be left in place.

4.  If possible, do not leave a body unattended. Once a responsible person (i.e. Coroner’s investigator, police, security, or family member) is present at the scene, you may be excused.

5.  NEVER transport/move a body without permission from the Coroner’s office, except for assessment or its protection.

If the body is in the public view and cannot be isolated, screened, or blocked from view, and is creating an unsafe situation with citizens/family, the body can be covered with a clean, STERILE BURN SHEET obtained from the EMS vehicle.