Date Published

September 11, 2017

Updated For

ALS PCS Version ALS PCS Version 5.2


Question: With respect to the updated July 17, 2017 medical directive changes, are hangings, electrocution and anaphylactic cardiac arrests considered reversible causes of arrest, and therefore subject to consideration for early transport after 1 analysis, OR are they to be run as full medical cardiac arrests/4 analyses, regardless of whether defibrillation is indicated? Thank you.


The best treatment we can offer the majority of cardiac arrest patients is high quality CPR and early defibrillation which is best performed on scene. In the cases exemplified above, this statement holds true. With an anaphylaxis arrest, a dose of epi can be given. Beyond that, the best chance of survival for these patients is high quality CPR and defibrillation if required. If a time sensitive intervention can be performed to reverse the cause of the cardiac arrest that falls outside of paramedic scope of practice (ex €“ highly suspect tension pneumothorax as cause of cardiac arrest and PCP crew on scene), then the directive allows for early transport. With that being said, in the vast majority of cases it is extremely difficult to ascertain the exact cause of the cardiac arrest. The majority of cases will result in running the full medical cardiac arrest directive with a focus on high quality CPR +/- defibrillation.



Epinephrine (Epi)

Additional Resources

No additional resources are available for this SWORBHP Tip.