When to stop resuscitation in ACLS – 2020 guidance

When the resuscitation is going on and there is no return of spontaneous circulation, we must stop our efforts at some point. This lesson will guide you on when to stop resuscitation in Advanced Cardiac Life Support (ACLS)

Rules to guide the termination:

  • If the arrest was not witnessed.
  • No bystander has started CPR by the time you reach.
  • No return of spontaneous circulation with on the spot CPR (before transport).
  • No shock was delivered (Meaning the AED was not used or Shockable rhythm was not detected by the AED (before transport).

If all the above criteria are present, consider termination of resuscitation as any more efforts might be futile and the chance of achieving an ROSC is unlikely

If any criteria from the list is missing, continue resuscitation attempts and transport to the nearest emergency facility for better care/resuscitation.

This also depends on the victims age and presence of any underlying comorbid conditions. Discuss with a senior if needed. Use your local guidance on whether to declare death on site or to move the victim to a facility to do so.

Back to: ACLS Advanced cardiac life support (2020 AHA) > Endpoint of resuscitation