During a medical code, after the first three shocks we are now doing a vector change. The directive states to then do 3 more shocks with the new pad placement. My question is if we only get one or two shocks following that pad placement change, are we now remaining on scene for the full 20 minutes since they’re no longer in refractory VF/VT or still leaving early since they were in that state and have shocked 4-5 times.

I was just wondering if SWORBHP is still maintaining the same stance for pediatric medical cardiac arrest (as discussed in the May 2022 Tip of the Week and other posts) for the new medical cardiac arrest directive in ALS PCS version 5.0? Is paramedic judgement still recommended for rhythms not amendable by defibrillation or is it expected that we run the cardiac arrest on scene for the full 20 minutes? I understand the research is trending towards scene times longer than 10 minutes for pediatrics (in some studies) and that earlier epinephrine administration has been associated with ROSC but this also leaves PCP only rural services in a very difficult grey zone to be addressed. I am by no means advocating for a “scoop and run” mentality (the new wording in the directive rules that out quite nicely) but any further guidance or clarification is greatly appreciated!