Maryland yearly protocol updates are out now, which is important to me especially because I’m a Maryland paramedic and one of the most significant changes is the update to our termination of resuscitation protocol.

Stop Transporting Dead People

EMSAmbo_smIn an effort to stop transporting dead people, the Maryland EMS protocols have changed their rules for stopping resuscitation efforts in the field. For a medical arrest, we will stop resuscitation after 15 minutes when three conditions are met.

  • First the arrest was unwitnessed by the provider.
  • Second, the patient is in asystole.
  • And three, there has been no return of a pulse during the resuscitation efforts.

It’s important to note that this does not apply to pregnant patients, pediatric patients or hypothermic patients. There are slightly different rules for trauma arrest patients. The new rules are there to keep ambulances from needlessly transporting patients, hopefully helping to prevent motor vehicle accidents and provider injuries in the field during transport.

CPR Impossible In Moving Ambulance

Dr. Bass, Maryland’s Institute of Emergency Medical Services Systems Executive Director, says “it’s impossible to perform CPR effectively in a moving ambulance.” I agree. Is your system moving forward with the recommendations of the American College of Emergency Physicians (ACEP), the National Association of EMS Physicians (NAEMSP) and others? I think it’s important to do this as well as begin tracking the truly survivable arrest numbers so we can begin tracking our success in performing CPR and resuscitation in the field. Let me know what’s going on in your system.

Shoot me an email to and share your thoughts with the members of the MedicCast community.


Follow-up on the link for this and other news items as well as all of the additional resource links in the show notes for this episode – EMS Med Review of Terbutaline and Episode 342.


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