[Out-of-hospital cardiac arrest: Choosing wisely whom to resuscitate].

Megyeri, Tamas; Regard, Simon; Larribau, Robert

Restrictions on the management of out-of-hospital cardiac arrest during the COVID-19 pandemic have challenged the previous « more care is better care » approach. By promoting both the reduction of no-flow delay and implementation of quality chest compressions, resuscitation guidelines have evolved in order to prevent neurological injury. At the same time, mechanical chest compression devices and extracorporeal membrane oxygenation (ECMO) have emerged, allowing for prolonged resuscitation. These new possibilities have made decision making more complex, while decision support tools have not evolved much. At each decision point, the futility of the measures envisaged must be considered. Better resuscitation for a better life means above all « choosing wisely » whom to resuscitate.