This unique, exploratory study provides new insights into ambulance personnel’s experiences of prehospital resuscitation decision-making. Managing the impact of termination of resuscitation and resulting scene of a death required significant confidence, psychosocial skills and experience. Commencing or continuing resuscitation was sometimes a default action, particularly where ambulance personnel felt the context was uncertain, unfamiliar or overwhelming. Factors appeared to be integrated in four distinct phases, described under four main identified themes: prearrival impressions, immediate on-scene impressions, piecing together the big picture and transition to termination of resuscitation. Participants sought and integrated numerous factors, beyond established prognostic indicators, when making resuscitation decisions. Semistructured interviews with a purposive sample of 16 demographically diverse ambulance personnel, currently employed in a variety of emergency ambulance response roles, around New Zealand.
The purpose of this study was to explore ambulance personnel’s decisions to commence, continue, withhold or terminate resuscitation efforts for patients with out-of-hospital cardiac arrest.
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