[Indications for and termination of resuscitation]

In the opinion of the American Heart Association [AHA] all patients suffering respiratory or cardiac arrest should be resuscitated unless 1. there are obvious signs of clinical death, 2. resuscitating the patient would place the rescuer/rescuers at significant risk of physical injury or 3. there is a documentation or another reliable person confirming that resuscitation is not wanted or in the patient's best interest. Once begun resuscitation should continue until one of the following occurs: 1. Return of spontaneous circulation and ventilation. 2. Care is transferred to another team of trained rescuers [physician, ECC team, etc.]. 3. Reliable criteria for the determination of death is recognized. 4. The rescuer/rescuers ar too exhausted to continue resuscitation or environmental hazards endanger the rescuers. 5. Valid no-CPR documentation is represented to the rescuers, either before the resuscitation has begun or during the effort. The psychological aspects of critical incident debriefing are described as are recommendations for conveying news of a sudden death to family members. In addition, the ethical points of organ transplants and practicing intubation on newly deceased persons are described.