METHODS: 170 (including 23 traumatic) out of 705 OHCA patients were successfully resuscitated (return of spontaneous circulation ROSC) at ER of CSMUH (from Jan 1st, 2011 to Apr 30, 2014). Only 33 (M: F = 25: 8) out of 147 medically resuscitated OHCA patients with one or more cardiac risk factors were transferred for emergency cardiac catheterization (33/147). 31 underwent percutaneous coronary intervention (PCI) procedure, one underwent coronary artery bypass grafting (CABG) and one underwent aortic valvular replacement (AVR). 8 patients (8/33=24.2 %) were survived to hospital discharge. However, 25 survived patients were in comatose state at ICU. Among them, 2 were transferred to respiratory care ward (RCW) and 24 eventually deceased after palliative and spiritual care. Another 6 OHCA patients required extracorporeal membrane oxygenation (ECMO) support but only one underwent PCI survived. We applied palliative and spiritual care for these 25 patients with nearly medical futility.