Reframing Prehospital Termination of Resuscitation as Withdrawal of Life Support: Applying Lessons from the ICU in the Prehospital Setting

Cardiac arrest response and management is a critical piece of prehospital clinical practice yet the majority of these patients do not survive to be transported. Termination of resuscitation and resulting death notification is stressful and emotional for both loved ones and EMS clinicians. We describe a fundamental shift from traditional termination of resuscitation to a patient and family-centered model. This new approach focuses on identifying appropriate situations to have family present at the time resuscitative efforts cease, and possibly throughout the entire resuscitation, thereby reframing termination of resuscitation as withdrawal of life support. This approach draws on best practices from hospital-based end-of-life care and holds the potential to reduce psychological trauma for both families and EMS clinicians.