Cardiac Resuscitation — When Is Enough Enough?

Cardiac arrest is a leading cause of death in the United States.¹ In spite of periodic updates of the Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care of the American Heart Association (AHA) (hereafter referred to as the AHA guidelines), survival rates are dismal in the absence of early defibrillation and have remained essentially unchanged for decades.^1,2 In large cities in the United States, overall survival of out-of-hospital arrest of presumed cardiac cause is about 1 percent — approximately the rate that has been suggested to define medical futility.^2,3 The cost of providing emergency medical services (EMS) to . . .