Termination of Resuscitation Rule (BLS / ALS)

Termination-of-Resuscitation rules (Morrison 2006 BLS / 2007 ALS): field decision support for non-traumatic out-of-hospital cardiac arrest.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Rule
BLS TOR (3 criteria)

Result: BLS TOR rule — all criteria met; termination of resuscitation may be considered.

The tool opens with these values already filled in. Replace them with your own.

What the result means

BLS
Termination may be considered when all three are true: arrest not witnessed by EMS, no ROSC before transport, and no shock delivered (specificity ≈ 90%, PPV for death ≈ 99.5%).
ALS
Adds two: arrest not witnessed by anyone and no bystander CPR (100% specificity for death in the derivation). Non-traumatic adult OHCA only. Field decision support, never a mandate to stop.

What you enter

  • Rule (BLS 3-criteria or ALS 5-criteria)
  • Arrest witnessed by EMS
  • ROSC before transport
  • Shock delivered
  • Arrest witnessed by a bystander (ALS only)
  • Bystander CPR provided (ALS only)
How this is calculated

Morrison LJ, Visentin LM, Kiss A, et al. Validation of a rule for termination of resuscitation in out-of-hospital cardiac arrest. N Engl J Med. 2006;355(5):478-487. ALS rule: Morrison LJ, Verbeek PR, Vermeulen MJ, et al. Resuscitation. 2007;74(2):266-275. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.