Hello, med students. My name is Zach Olson, and thank you for downloading this week's

episode of the EM Clerkship Podcast. If you've done at least one emergency medicine rotation,

you've probably seen a code in the ED, CPR, A-CLS, the megaacode, right? These are pretty common.

And this is a quick episode, but one of the questions I always had, and this isn't

going to be like on your test or anything, but like when does the attending decide, like,

I think we should stop the code.

Stop CPR.

It's easy to start CPR.

Anybody can do it.

But it's hard to know when to stop.

And I will say my opinion has evolved on this over the years, but I believe now, generally

speaking, and assuming that we can even predict

this, that it doesn't make sense to, quote, save somebody if they have zero percent chance of

neurologically intact outcome or survival to discharge. They're just going to die three days later in the

ICU,

and there are patients that can be saved that do need our attention,

waiting for you in triage, waiting for that ICU bed,

with that sweet, sweet, two-to-one patient to critical care nurse ratio,

where much good can be done if resources are allocated wisely. And much harm can be done if resources are allocated wisely and much harm can be done if you push the code too long remember rask getting a pulse return of spontaneous circulation does not equal

survival it doesn't always mean like oh yay, yay, good outcome. For all of you U.S.

EMS out there, I know your protocols are pretty fragmented from region to region, but generally,

I'm pretty sure your basic guideline is to stop CPR if there are definitive signs of death like rigor mortis

...