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What contradicts a medical TOR?

  1. Anaphylaxis suspected

  2. Arrest believed to be of non-cardiac origin

  3. No obvious ROSC

  4. No shocks delivered

The correct answer is: Arrest believed to be of non-cardiac origin

The correct choice relates to the medical Termination of Resuscitation (TOR) protocols, which provide guidelines for when resuscitative efforts can be discontinued. An arrest believed to be of non-cardiac origin typically suggests that there may be a reversible cause for the patient’s arrest, which could justify continuing resuscitation efforts rather than initiating a TOR. In contrast, if anaphylaxis is suspected, it indicates a potential for a treatable condition that could respond to immediate intervention. The presence of no obvious return of spontaneous circulation (ROSC) alone is not a definitive indicator for a TOR under certain circumstances, as it could be followed by a response. Lastly, not delivering shocks alone doesn’t constitute a contradiction to a TOR, as the criteria for TOR may take into account other elements such as the patient's overall condition and the context of resuscitation efforts. Thus, the belief that the arrest is of non-cardiac origin likely contradicts the rationale for allowing a TOR, emphasizing the importance of treating potentially reversible causes before making a decision to cease resuscitation.