Ignore the guidelines. If they fire you sue the state.
Aaah, yes. Once again the Lawyers win.
And, you, the EMT, are without a job while your case slowly winds through the courts. 10 years later, you and 999 other EMTs receive $2,500 from the $25 million 'Class Action Settlement'. The law firm handling your case gets 40% ($10 million), plus another $12.5 million in 'Legal Expenses'.
Hey, secretaries, photocopies and 'business lunches' while taking depositions cost money.
Dedicated first responders may finesse the timing of a cardiac arrest by "finding" a weak and thready pulse with respiratory arrest which requires immediate intervention. After loading the patient into the ambulance, they may declare the patient has a cardiac arrest. That's what I would do if faced with this dire NYC directive.