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.  

Since defibrillation was delivered, this patient does not meet the Conditions for the Medical TOR. Therefore, you do not need to stay on scene for the full 20 minutes. In the situation that you describe, you would initiate transport after the shockable rhythm is terminated. Please see the SWORBHP Memo from July 19, 2023 titled “Cardiac Arrest Medical Directive - Direction for non-TOR patients” for full information on Medical Council direction for patients who do not meet the Medical TOR criteria. 

Cardiac/Circulation,Medical Cardiac Arrest

20-minutes, DSED, Medical TOR, Refractory VT/VF, Transport, VCD, Vector Change Defibrillation

MEMO