RIchard Steggall
Journal of Paramedic Practice, Vol. 1, Iss. 11, 01 Aug 2009, pp 460 - 464

This case study covers an incident when the decision of whether to recognize life extinct (ROLE) at an out-of-hospital asystolic cardiac arrest resuscitation attempt after 5 minutes or to complete the full 20 minutes of resuscitation as recommended by the Joint Royal Colleges Ambulance Liaison Committee guidelines, when the cause of cardiac arrest was undetermined, was required. It was also necessary to weigh up the benefits of when to, or indeed if to, transport the asystolic patient by helicopter to the district general hospital.
This incident provided evidence of what could have been a cardiac arrest prior to trauma but also trauma followed by cardiac arrest. Questions posed by this incident included whether the introduction of a 1-month trial period of a doctor on the helicopter assisted the crews in the decision-making process or changed the dynamics of the group and the normal decision-making process.

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