Problem in initial patient assessment: a hypothermic patient may have an undetectable pulse
Endpoints: resuscitation or death
Indications for resuscitation - both of the following:
(1) one of the following:
(1a) cardiac arrest
(1b) respiratory arrest
(1c) respiratory distress (in order to prevent cardiac arrest)
(2) submersion for < 60 minutes
An automated external defibrillatory (AED) may be beneficial if the cause of submersion is a cardiac arrhythmia.
When to discontinue CPR or advanced life support:
(1) obvious signs of death (rigor mortis, decomposition, etc)
(2) asystole for > 20 minutes once normothermic
(3) physical collapse of the response team
(4) presence of signs of life
