Dealing with death and gore

[paramedicmike]

Why did you do an ekg on a rotting corpse?

Because too many moronic EMS providers arrive on scene, say the person is dead after little more than a cursory glance, only to be called back to the morgue when the "dead" person wakes up. These stories hit the news every once in a while. It's generally bad press for all involved.

So, EMS docs have to dictate protocol to the lowest common denominator.

Edited April 23, 2010 by paramedicmike

[emtannie]

We have the same protocol....... it is a friggen joke if you ask me.

Really mobey? I thought that protocol was changed, as we "are all one" under AHS now...

If there are obvious signs of death, you don't have to do the 1 minute strip... (although I did have an incident several years ago, where I was reprimanded for being sarcastic to dispatch, because I was called to a possible death... got there, the man had been dead for some time in late July heat in an un-air conditioned house... obviously, the body was in rigor, had lividity, was bloated, and decaying. I called in to dispatch that death was confirmed, and the dispatcher said "Are you sure?" Without thinking, I replied, "Well, aside from the rigor, lividity, and bloating, I'm pretty sure." They filed a complaint that I was too sarcastic.... but I certainly wasn't questioned as to why I never ran a strip)

But, if your powers that be still want a strip, I guess you have to entertain them with one.

I figure the mnemonic DRIED is pretty good for deciding whether to run a strip.. (Decapitated, Rigor, Incinerated, Eviscerated, Decayed)

Edited April 23, 2010 by emtannie

[mobey]

Really mobey? I thought that protocol was changed, as we "are all one" under AHS now...

If you work in a "contract back" service your protocols are unchanged.

Once AHS takes us over we will be revising protocols to what the new Med Director wants.

[emtannie]

If you work in a "contract back" service your protocols are unchanged.

Once AHS takes us over we will be revising protocols to what the new Med Director wants.

Ahhh - thanks for clearing that up for me! (I have been part of "the borg" for a while, so wasn't sure about contracted services)

[Siffaliss]

We have the same protocol....... it is a friggen joke if you ask me.

Even if they're obvious x 7 days?

I know it's done under certain circumstances such as last seen a few hours ago, no signs of life or viability, perhaps peripherally cool but centrally warm ... but several days?

[Kiwiology]

Ambulance Operations Manual 11.7

Establishing that a person has died

Qualified Ambulance Officers may sign the New Zealand Police Deceased Person Certificate (form no. ASOP 034).

In determining that a patient is dead, the following guidelines are followed:

• the patient is unconscious and

• has no respiratory effort and

• has no palpable carotid or femoral pulses

The examination occurs over a period of one minute.

Five minutes later, the examination is to be repeated.

Asystole is to be confirmed in all three leads (emphasis added)

[Dustdevil]

LOL@all three leads

You guys aren't seriously carrying 3-lead machines, are you?

Paramedicmike is, unfortunately, right. We have to dumb it down to the lowest common denominator, especially in the US, where our common denominator is criminally low to begin with.

I like the 5 minute recheck thing. That's an excellent idea.

[gemini1030]

Thanks everyone for the responses. I talked to my regular partner last night about it and she agreed with everyone here. There was no emotional or physical effort in a code and no trauma so it is just a normal part of life. I understand that everyone must die and there is nothing that we can do about it. Do your job and sometimes it is just that person's time to go.

The strip is a part of protocol in our area. We just ran a 3 lead to have for our records and a copy for the coroner. The monitors that we use are capable of both 12 and 3 leads.

Thanks again for the support and advice.

Be safe everyone.

[stcommodore]

So I guess whoever gave me the negitive comment didn't get my attempt at humor. If you have any doubt run an EKG, but be a health care provider not a drone.

[joesph]

Why are we suppose to be mortified of death? It is the eventual outcome to life. Sometimes a death will make me angry or sad that the person is gone but that's about it. As far as leaving a mark otherwise I don't see why. If someone dies that we are working very hard on I suppose I feel disappointed. I do feel that if we are to be with a person that is in the last moments of there life we have a profound opportunity to give them dignity and grace at there end time.