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Cardiac arrest
Agencies vary widely on withholding and stopping CPR
Emergency medical services agency-level variation in non-initiation of resuscitation and termination of resuscitation in out-of-hospital cardiac arrest
Resuscitation · 2026-11 · Added 26 September 2026
A retrospective US cohort of 560,240 non-traumatic OHCA encounters found large between-agency variation in non-initiation of resuscitation (median OR 2.30) and termination-of-resuscitation decisions (median OR 4.13) even after adjustment for patient and agency factors.
- Study type
- Cohort
- Design
- Retrospective multi-agency cohort (mixed-effects models)
- Participants
- 560,240 EMS encounters with non-traumatic OHCA, 2018–2024
- Main finding
- Resuscitation was not initiated in 13.7% and the Universal TOR rule was applied in 56.9% of eligible cases; median odds ratios were 2.30 for non-initiation and 4.13 for TOR
- Caveat
- US agency mix and documentation practices may differ from Australian services; residual confounding by unmeasured case factors
- Bottom line
- Supports current practice
Why it matters in Australia (High relevance). Decisions to withhold or stop resuscitation are made by paramedics under the same kind of universal termination rules used across Australia, so unwarranted variation is directly relevant to practice consistency here.
Learning goal
Understand how system and clinician factors drive variation in withholding and terminating resuscitation in cardiac arrest.
More
- Topic: Cardiac arrest
- Daily scan: 26 September 2026
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