Another death determination FAIL

[Dustdevil]

http://www.foxnews.com/story/0,2933,536312,00.html

Baltimore EMTs 'Reassigned' After Mistakenly Declaring Man Dead

Monday, August 03, 2009

Associated Press

Baltimore police say a burglary suspect laid on the floor of a convenience store for about a half-hour with a gunshot wound to the head before officers noticed he was still alive.

Police spokesman Anthony Guglielmi says 51-year-old Michael Quarles was shot by an officer after he lunged at the officer with a long screwdriver early Saturday. The officer initially thought Quarles was wielding a knife.

Guglielmi says emergency medical technicians responded to the scene and pronounced Quarles dead, then left. About 30 minutes later, he says the officers noticed Quarles moving. The EMTs were recalled to the scene, and Quarles was taken to a trauma center. He remained in critical condition on Monday.

The city's fire department is investigating the EMTs, who have been temporarily reassigned.

[spenac]

EWWWWWWWWWW GROSS theres blood and brains I ain't touching them. They're dead hurry lets leave.

Maybe we would just be better off being taxi drivers, its pretty obvious a lot of EMS people have no education.

[chbare]

This in no way excuses the EMT's; however, I understand there is tension between EMS and the police over the crime scene. I remember a past news clip regarding the police complaining about disturbing the crime scene. Possible pressure from the officers on this call?

However, what is wrong with people. You have to actually perform an assessment, yes? You know, assess for breathing, pulse, listen to the heart and lungs, look at the pupils, and obtain an ECG tracing in a few different leads. Just a thought.

Take care,

chbare.

EDIT: I think this article was covered on an earlier newsbot post?

Edited August 4, 2009 by chbare

[WolfmanHarris]

Seriously how hard is it to recognize life/death? I know a hundred hours isn't a lot of time but we're not talking an issue of obviously dead (non-salvageable) vs. workable arrest, we're talking alive vs. dead. For f**k's sake if we can't get this one right every arrest is going to be worked, head attached or not.

Word of advice for determining death:

1) Are they awake? If so, not dead. (Good so far? Let's move on.)

2) Are they moving? If so, not dead. (Still with me?)

3) Do they respond to yelling or pinching? If so, not dead. (What we call verbal and painful stimuli. Technical I know.)

4) Are they breathing? If so, not dead. (Now this get's complicated; make sure the airway is open first.)

5) Do they have a pulse? If so not dead. (Now, make sure you've not checked with your thumb AND actually know where the carotid is. TV not withstanding, the wrist is probably not your best bet.)

6) Do they have injuries incompatible with life? (Note that this part comes after everything else. The bad boo-boo to the head with the gross stuff coming out may mean dead, but not until you've checked all of the above.) If so, consider the following:

- Do they have a pupillary response?(That means, do they change size when you shine that light you carry around at them)

- Is their monitored HR zero? You know, Asystole? (That's the dramatic flat line that usually cues commercials on TV.)

Hopefully this list may help you. (Whoever "you," future defendant may be.) It's obvious you're likely too stupid/ignorant to continue in a career where people's lives may be affected. It is my hope that with this list your inevitable failure and exit from my profession will not cost anyone their life.

Please ensure you collect your burger king application on the way out.

Kind regards,

- Competent, Professional Paramedics.

Edit: Edited for spelling/grammar. Also, apparently I get snippy when I type with an eye ache. (Yes I said eye ache. Long story.)

Edited August 4, 2009 by docharris

[VentMedic]

It appears the same Paramedics were called back to take another look. It also seems there is some confusion amongst the Paramedics and Police as to "signs of life" and calling patients at scene.

The earlier article:

Dead, not dead, at shooting scene

Baltimore paramedics prematurely pronounced a patient dead over the weekend while at the scene of a police involved shooting in Northwest Baltimore. The Sun's Richard Irwin reports that an investigation is underway by the Baltimore Fire Department (at left, din a photo by The Sun's Glenn Fawcett, detectives stand over a body at a homicide scene in West Baltimore).

This comes just a few months after we heard complaints from homicide detectives that paramedics were following new rules and taking even obviously dead patients to hospitals, marring crime scenes. Detectives like having their scenes untouched, including bodies, so they can learn as much as they can.

This case stems from a shooting by a city officer of a burglarly suspect at a grocery store. Cops say the man lunged at officers with what appeared to a knife but turned out to be a screwdriver. The man was hit in the head and paramedics prounced him dead at the scene and left.

But later, homicide detectives noticed that man either moved or made a sound and called the paramedics back. The man was taken to Maryland Shock Trauma where he remains in critical condition.

Fire commanders are investigating what went wrong. We had heard from cops and paramedics that they are quick to transport at even the slightest sign of life. One paramedic told me that "if we see life, we do something." Even obviously dead patients sometimes get treatment, the paramedic told me, such as when a man has been shot in public and his friends and family are around. The paramedics want to make sure the family sees that everything possible has been done. The paramedic told me that in one case, an elderly woman died in a nursing home and she was instructed to take the victim to the hospital anyway.

"If it was my son up there, I'd want somebody to do something," the paramedic told me. "If they guy is lying on the porch and his relatives and family are all around, I want them to know that I worked him."

Some homicide detectives have complained that bodies are being moved unnecessarily, complicating their efforts at scenes. But Robert Cherry, the president of the police union and a former homicide detective himself, said he hasn't heard any grumbling.

"A lot of our detectives want to spend a little more time at crime scenes looking at it the way it was," Cherry said. "But I can see a paramedic saying, 'I'd rather have Shock Trauma pronounce the person dead.' If there is even the slightest chance of survival, EMS has to do their duty and protect life. Where a body is there or not, we'll still do our jobs."

Edited August 4, 2009 by VentMedic

[spenac]

. But Robert Cherry, the president of the police union and a former homicide detective himself, said he hasn't heard any grumbling.

"A lot of our detectives want to spend a little more time at crime scenes looking at it the way it was," Cherry said. "But I can see a paramedic saying, 'I'd rather have Shock Trauma pronounce the person dead.' If there is even the slightest chance of survival, EMS has to do their duty and protect life. Where a body is there or not, we'll still do our jobs."

RRRRIIIIIGGGGGHHHHHTTTTTTTTTT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

But he made sure and got out the police union side out in the media which is deny deny deny. Of course EMS being so disorganized and uneducated will take all the heat. Just look at the ignorant uneducated we take everyone even obviously dead statement.

[VentMedic]

RRRRIIIIIGGGGGHHHHHTTTTTTTTTT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

But he made sure and got out the police union side out in the media which is deny deny deny. Of course EMS being so disorganized and uneducated will take all the heat. Just look at the ignorant uneducated we take everyone even obviously dead statement.

Police union or not the Paramedics should know their job and have the support of their medical director when either working or not working a patient. However, in this situation, they left the scene with a live patient laying there and it WAS THE POLICE that called them back. That sorta puts the PD in better light than the Paramedics in this situation.

I think there should also be clarification between "obviously dead" and the "newly dead but not obvious". For the "obviously dead" even an EMT-B or layperson would probably have little difficulty in calling that.

[mobey]

- Is their monitored HR zero? You know, Asystole? (That's the dramatic flat line that usually cues commercials on TV.)

What about PEA....

Just playin Doc

[WolfmanHarris]

What about PEA....

Just playin Doc

My bad, I was channeling my trauma arrest protocol I think. PCP penetrating trauma TOR specifically requires asystole on 3 lead, no pupillary response on a >16y/o VSA.

[EMS49393]

That city is as f***ed up as a football bat right now. They have a mayor that is currently under indictment for a host of charges, including theft of gift cards intended for needy people. They have a fire department that is so disgruntled they may never be able to function effectively again. They have this ridiculous academy that spits out intermediates faster than you can count them. They appear to hate their new fire chief despite his repeated efforts to work with those guys on the issues that concern them. It's no wonder this happened.

It's more than obvious those people don't even want to be there judging from what is read on a fire forum of theirs. I don't know if I'm allowed to post the site where they have a forum for their department, but if you're interested in reading some whining and carrying on about how bad they have it, feel free to PM me and I'll link you to it. It's actually a pretty comical way to pass an afternoon. It beats a soap opera.

In my opinion, the paramedics are at fault, period. I don't care what the police want you to do, when it involves a patient, they come first, and that includes assessing whether or not they are dead at a crime scene. I'll do everything I can to preserve their scene, but I have to ensure that any potential patient is taken care of as well. It was a fail, period.