Extended Resuscitation: Rescue Efforts Show Promise, Even After 25-Minute Mark

While it’s commonly thought that CPR and other life-saving rescue efforts offer diminishing returns after a few minutes, recent data suggests that persistence can pay off.


A recent case in North Carolina showed that there is indeed promise for continuing rescue efforts for victims of cardiac arrest 25 to 30 minutes beyond initial response.


The Wake County EMS System (WCEMSS) studied a recent resuscitation, where a man had been unresponsive for a half-hour after vomiting his sports drink. Through a combination of an automated external defibrillator (AED), an impedance threshold device (ITD) and CPR rescue breathing and chest compressions, first responders have been able to maintain something called neurologically intact survival (NIS), which ultimately determines a victim’s chance or returning to a normal lifestyle after sudden cardiac arrest and prolonged rescue efforts.


The key point in the WCEMSS data concluded that there are no reasons to stop procedures like CPR, ITD or AED. In fact, an amazing case surfaced that documented NIS survival at the 73-minute mark – well beyond the previous 25 minutes safety experts recommended.

So, it seems that “sticking with it” really does pay dividends, even when all hope is seemingly lost. Bottom line: when it comes to extending ITD, AED or CPR beyond the standard 25-minute mark, first responders should use sound judgment.


Among other factors, two critical characteristics that would possibly merit rescue efforts beyond 25 minutes include normal rate narrow-complex pulseless electrical activity and at least normal end-tidal carbon dioxide (EtCO2) measurements.


This blog shows (again) how important CPR response is. From the first few seconds to perhaps well past the 25-minute mark, CPR provides air flow and oxygen to vital organs – and this can eventually positively impact NIS.


If you’d like to receive the best CPR instruction, SureFire CPR is the #1 rescue training center in Southern California. Along with our CPR, we also have PALS (pediatric advanced life support) and NRP (neonate resuscitation program) classes and many more!


Call (888) 277-3143 to get started today. Plus, the SureFire CPR contact page has more information for getting in touch.

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About the author

I spent 15 years as a firefighter and paramedic...

And too often I would arrive on the scene of someone unconscious, surrounded by a circle of people feeling helpless. Sometimes those people would even have CPR training but lacked the confidence and experience to act.

That’s why I started SureFire CPR. Our classes are practical and engaging – teaching you the crucial skills you need to know what to do and feel empowered to take action.

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Zack Zarrilli, Founder

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