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EMS arrives to your ED with a 60-year-old man in cardiopulmonary arrest.

EMS arrives to your ED with a 60-year-old man in cardiopulmonary arrest. He has a history of three prior heart attacks and cardiac stents due to severe coronary artery disease. EMS tells you that he has been pulseless for 10 minutes. You immediately continue resuscitative efforts via advanced cardiac life support (ACLS) guidelines. After several administrations of ACLS drugs and several rounds of cardiopulmonary resuscitation (CPR), you are contemplating terminating the code due to medical futility. Which of the following factors would lead you to continue your resuscitative efforts?

a. The patient’s arrest witnessed by a bystander or EMS who immediately began CPR.

b. Before the cardiac arrest, the patient has been compliant with taking his cardiac medications.

c. The patient has an automated implantable cardioverter-defibrillator (AICD).

d. The patient has previously survived an out-of-hospital cardiorespiratory arrest.

e. The patient’s initial out-of-hospital rhythm was asystole.

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