Medical Cardiac Arrest Medical Directive:

• For ALS PCS 5.0 and beyond, the Medical Cardiac Arrest Medical Directive was revamped, with the "Primary Clinical Considerations" listed first for reasons to depart scene early, due to reversible (treatable) causes​
  • Some examples of reversible causes are explicitly defined (see next slide 1. through 4.)​
  • HOWEVER, point 5. "other known reversible causes of arrest not addressed" is more nebulous​
    • THEREFORE, let's look at an approach we discussed at MCME 2023 to consider reversible causes of arrest

Hs and Ts: An Approach to Reversible Causes of Arrest:

The Advanced Cardiac Life Support (ACLS) course gives an approach for thinking of reversible causes of cardiac arrest: The Hs and Ts

NOTE:

• This series is intended for educational purposes ​
• The information provided can hopefully help inform your clinical judgement during resuscitation calls​
• It is not meant to increase the cognitive burden of resuscitation calls - hopefully, the opposite!​
• The Hs and Ts tool is to simply help to identify whether a reversible cause might be at play (from what is readily known/apparent)​
• Otherwise, continue standard treatment per the medical directive

Summary:

ALS PCS 5.0 and above has a restructured look, with the "Primary Clinical Considerations" of when to depart scene early in the setting of Medical Cardiac Arrest

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