2026 Volume 29 Issue 1 Pages 45-53
Background and Objective: There have been cases where emergency medical services (EMS) personnel dispatched via 119 emergency calls in response to cardiac arrests in patients at the end of life are informed by family members or related parties that cardiopulmonary resuscitation (CPR) is not desired. This survey aimed to clarify the status of policy development, operational practices, and challenges in addressing such situations.
Methods: An online questionnaire survey was conducted from February 2025 targeting all 720 fire department headquarters nationwide.
Results: Responses were obtained from 570 headquarters (79%). Forty-two percent had established “policies allowing termination of CPR at the scene if certain conditions are met,” while 40% had “no established response policy.” In 4.8% of cardiac arrest cases, wishes against CPR were expressed, and in 16% of these cases, CPR was terminated before hospital transport. Many headquarters placed emphasis on online instructions from the patient’s primary care physician, and transport policies after termination varied widely.
Conclusion: Initiatives regarding the implementation of CPR respecting patients’ wishes are expanding, but regional disparities exist. Future challenges include strengthening coordination with regional medical care and promoting information sharing among stakeholders.
