Working a code alone in the back?

[babyblade6]

Haha CaliMedic209, I know you know what I mean, but I should have been a little more clear on that! Lets try again... we declare our dead patients on scene and we dont declare them at hospital. Lol We will take good care of you here in South Africa, promise!

[Richard B the EMT]

There seems to be an unspoken agreement with all of the EMS providers here in the USA:

They are either dead at the scene, or dead at the hospital, as nobody dies in the ambulance during the trip to the hospital!

Any commentary from outside of the US?

[spenac]

There seems to be an unspoken agreement with all of the EMS providers here in the USA:

They are either dead at the scene, or dead at the hospital, as nobody dies in the ambulance during the trip to the hospital!

Any commentary from outside of the US?

I disagree Richard. I have had many die in the ambulance. I have actually diverted to meet funeral home crew. And if I'm doing CPR when I arrive at the hospital they are dead at that point. I hate the statement nobody dies in my ambulance. It is a bunch of crap.

Also note I don't do rolling codes. If I'm doing a rolling code it means they code enroute to hospital and I chose to work them as we pull up to the hospital. But as we are doing CPR they are dead. You do not do CPR on live people.

[firedoc5]

I disagree Richard. I have had many die in the ambulance. I have actually diverted to meet funeral home crew. And if I'm doing CPR when I arrive at the hospital they are dead at that point. I hate the statement nobody dies in my ambulance. It is a bunch of crap.

Also note I don't do rolling codes. If I'm doing a rolling code it means they code enroute to hospital and I chose to work them as we pull up to the hospital. But as we are doing CPR they are dead. You do not do CPR on live people.

I can't remember but in a thread a long time ago, Spenac, that you and/or your agency can declare death? Are you also a Deputy Coroner or equivalent? I'm by no means calling you out, I just recall something like that.

I really wish we could have. No matter when or where, if we had a very obvious death at the scene we still had to wait for the Coroner's office to arrive. Or at least have one person wait. It was a real drag sometimes. By law, even if they are decapitated we have to wait for them to be declared by either a doctor or Coroner.

[spenac]

I can't remember but in a thread a long time ago, Spenac, that you and/or your agency can declare death? Are you also a Deputy Coroner or equivalent? I'm by no means calling you out, I just recall something like that.

I really wish we could have. No matter when or where, if we had a very obvious death at the scene we still had to wait for the Coroner's office to arrive. Or at least have one person wait. It was a real drag sometimes. By law, even if they are decapitated we have to wait for them to be declared by either a doctor or Coroner.

We have right to decide not to start cpr and we have right to decide when to stop cpr. The justice of the peace will meet us and sign the death statement even though they have no medical education. If they are not available we call hospital and tell the doctor the patient is dead and all efforts have ceased and he/she makes official time based on what we say. Most places seem to require you continue till doctor authorizes stoppage, here we stop when we decide that all further efforts are pointless. But actual legal pronouncement of death is either justice of peace or doctor. We do not have to remain on scene with the body if another call comes in. LE will wait and have JP sign the death certificate to make it official.

No you did not call me out, so no offense taken. You either misunderstood what I said or I used a wrong term. Hope I cleared that up, sorry for the confusion.

[Just Plain Ruff]

Spenac, I think you are in a rather unique position and area though. I seem to remember that your routine transports can be more than an hour or so away from a hospital. It seems that this would be the perfect place for medics to be able to decide when to stop a code. It's pointless to work a code from point a to point b if that would necessitate working it for more than an hour.

I think that's the right thing to do. I know your service and the docs you work with respect you guys and that's a good thing too.

[spenac]

Spenac, I think you are in a rather unique position and area though. I seem to remember that your routine transports can be more than an hour or so away from a hospital. It seems that this would be the perfect place for medics to be able to decide when to stop a code. It's pointless to work a code from point a to point b if that would necessitate working it for more than an hour.

I think that's the right thing to do. I know your service and the docs you work with respect you guys and that's a good thing too.

Yes what is now my part time job is very unique and yes it is 90 miles from the station to the hospital, with very limited communications. We do work more independently there than I am able to at my current full time job.

My current full time job is much more like others here but we still do not do rolling codes unless they code on the way to the hospital. If we do have a rolling code the driver is instructed by me to stop at every stop sign, red light, and to slow down for turns. I also instruct them to let us know when they are approaching a stop or turn so we do not get caught off guard, but mainly this makes the person driving avoid getting the L&S hypnotism.

[RomeViking09]

I work at a 1/2 volly 1/2 paid service, if I am on the BLS transport truck and a call for possible arrest or pt with cardiac Hx goes out I will hop on the ALS truck so they have an EMT to work with the medic in the back. Most of our other volly basics do the same. 1 time we had a call and I was driving the ALS truck and we did not have an extra EMT around the station but FD was on scene so one of the FF drove us in.