Changes to take place on July 1, 2013.
Beginning July 1, 2013, patients suffering a cardiac arrest will receive a minimum of 15 minutes of High-Performance CPR by Emergency Medical Service (EMS) providers prior to being transported to the nearest hospital emergency department.
Currently, Emergency Medical Service (EMS) providers transport cardiac-arrest patients to the nearest hospital as quickly as possible, all while attempting to treat the individual enroute. Statistics show, however, that this practice has not increased survival rates. Based on recommendations from the National Association of Emergency Medical Services Physicians and the Office of the Chief Medical Examiner of Maryland, as well as the American Heart Association, the Maryland Medical Protocols for Emergency Medical Services Providers has opted to change the initial treatment rendered to cardiac-arrest patients.
Studies have shown that patients suffering cardiac arrest have the best outcome when CPR and early defibrillation is performed as quickly as possible after the onset of cardiac arrest. As previously stated, High-Performance CPR will be administered for a minimum of 15 minutes prior to any transport attempt. Additionally, there will be a renewed emphasis on performing chest compressions at the proper rate and depth, with no interruptions. With these changes, crews will no longer be scrambling to move the patient to the waiting ambulance. Instead, they will be on-scene for a minimum of 15 minutes, performing high quality CPR, unless a pulse is regained, facilitating an earlier transport. This new procedure will ensure a calm and organized transport of patients suffering from a cardiac arrest.
An additional change in the Maryland Medical Protocols for Emergency Medical Services Providers allows for EMS providers to terminate resuscitation efforts of patients who do not respond to the best available medical treatments. When a patient suffering cardiac arrest receives high quality CPR and defibrillation (if required), and does not regain a pulse within 15 minutes there is little, if any, chance for survival. This new provision will protect EMS providers and the public from the inherent dangers of a fast-paced ambulance transport.
There are three exceptions to the termination of resuscitation protocol for EMS providers. They are as follows:
1. The cardiac arrest is secondary to hypothermia or submersion underwater.
2. The patient is pregnant
3. The patient is under 18 years of age.
If a patient falls into any of these three categories, they will receive appropriate treatment on the scene and then be transported rapidly to the hospital emergency department.
If resuscitative efforts are terminated in the field, EMS providers and Law Enforcement officers will remain on-scene to assist family members in any manner needed.