What should we consider when applying termination of resuscitation rules?

Historically, following full resuscitative efforts by emergency medical services (EMS), out-of-hospital cardiac arrest (OHCA) patients are transported to the hospital for continued resuscitation efforts at the emergency department. However, in patients in whom the chance of survival is deemed negligible, terminating resuscitation efforts in the field may be considered. In East Asia, EMS personnel are not legally permitted to terminate resuscitation, but field termination occurs in 40–60% and up to 40% of patients in Europe and the United States, respectively (1-4). The adoption of termination-of-resuscitation (TOR) rules may decrease the unnecessary consumption of valuable resources and number accidents during emergency transport (5).