Dealing with death and gore

[Don1977]

OK, I am very new to EMS and had my first call to a DOA. It was an older lady and she had been down for several days, maybe a week. For some reason it did not seem to phase me. Is that normal? I am more concerned with the fact that it seemed so routine and was not in the least bit upsetting or anything. I did help hook her up to a 3 lead to run the strip. We had a student doing clinicals and he had never done a 3 lead so he and I hooked them up and printed the strip. Is this normal or should I be concerned about my reaction. For some reason I thought that this would bother me more.

Never bothered me, suctioning doesn't either..........weird.

[Kaisu]

Death, even of very young people, does not bother me as long as I know everything that could have been done was done. If the call is a cluster, then I have more difficulty; not because of the fact of the death but because of the error(s) made during the call. My very first code as a student was 3 1/2 months old. I was better than OK because I managed to be a comfort to the family.

I have run on some pretty gruesome stuff, including a guy tortured with a box cutter, a guy who blew half his face off, one old fellow who had flies laying eggs on the open sores all over his body, a woman hit in the head with a bag of chains in a jeep rollover, etc etc. None of these bothered me.

I just about lost it over a child sexual abuse survivor that I spent 1 1/2 hours talking into the hospital because she was afraid her abuser would find her, only to have her returned to the abuser the next day.

There are way worse things out there than death.

[boeingb13]

What I have come to find is after you've been through the schooling, EMT-B and Paramedic. You dont look at scenes as you would if you never went to school, instead of seeing a bloody mess, you see blood pooling in the lower areas of the body. You notice the the transitions the body goes through after death, as opposed to the horror of it. Maybe its just me but after school I never looked at scenes the same as say, people riding by or friends/family who found a deceased family member.

[Siffaliss]

They filed a complaint that I was too sarcastic....

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

Annie my friend, you are funny when you're sarcastic! How come I've never heard of that pneumonic?

The others were right when they said "lowest common denominator". I'd like to say that to be in this field one is required to have a certain degree of common sense. Laziness can sometimes prevail and mistakes are made, which is why protocols such as some discussed here are in place.

[funkytomtom]

Good responses all! I wouldn't be worried about not being bummed after a call like that. I think that's probably a strength as long as you can still empathize and treat with care.

I'm going to go ahead and be the wuss here, however, and say that I've been very affected by some of the calls I've had. One was a train-wreck of a call with two infant deaths, but others weren't that dramatic. I try to just use it to my advantage and really truly help my patients in any way I can (as I'm sure we all do).

I think you can be a strong provider in either of these categories. Just accept who you are and how you handle it, keep the patient's well being as your main priority (after your crew), and you're on the road to greatness!

[Kiwiology]

LOL@all three leads

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

No, we have the LP12/MRx although there are one or two Lifepak 10's around still on spare vehicles and as backup.

Oh how I love the LP10

[Siffaliss]

No, we have the LP12/MRx although there are one or two Lifepak 10's around still on spare vehicles and as backup.

Oh how I love the LP10

LP15 is pretty cool, I can hardly wait until it starts rolling out here.

[EMS49393]

Death has never bothered me, which is a good thing since the first night back from medical leave had me bless two DOA's and work a cardiac arrest. I'm a bit of a magnet for the nasty deaths as well. I agree with what was stated above, don't bullshit yourself into believing you're not bothered when you really are. Although dead calls never got to me, I did have a period of a near nervous break down a few summers ago because I keep running critically ill kids. I'm talking end-stage cancer bloated, seizure kids and kids with horrific deformity and disability. The pediatric "nursing home" was in my first due area for a year, and they never called until it was really bad. I started seeing all of those kids when I would close my eyes to sleep. I started smoking so I could stay awake, I had horrific insomnia. On top of it, I felt guilty because I should be tough and able to handle any of these calls without a problem. I got help real fast, and I'm glad I did. I'm pretty well-adjusted now. (Aside from the fits of sarcasm)

I wouldn't over analyze your response too much because you'll continue to relive those calls instead of letting them go.

As for the ecg thing. I hate to say this, but I'm not sure if I have to run one or not where I am currently. I will say this, if I think at all that there is a crime scene, I do on what is absolutely necessary to determine death. I look at skin signs, rigor, pooling, breathing, feel for a carotid, and I check an apical pulse. If I listen and hear nothing, they are cold, decaying, not breathing (obviously), I determine death and let the police handle the rest. Some places I've worked made you determine death in this fashion because if you thought they were alive enough to attach a monitor, they haven't been down long and should be worked. It's a little foolish, but that's how the protocol was written. Unfortunately, we have several medics in our field that are unable to determine if someone is indeed pulseless and apenic, so I can understand the service wanted an ecg.

[Kiwiology]

LP15 is pretty cool, I can hardly wait until it starts rolling out here.

Yeah but the LP10 looked awesome in that bright red case and its big black paddles which inspired confidence not like those wimpy sticky pads.

And besides I grew up in the 90s when a certian alcoholic, nymphomaniac, prostitue loving lawyer with a man girdle and LP10 as co-host made us believe we could save people every Tuesday :D

Edited April 26, 2010 by kiwimedic

[spenac]

Yeah but the LP10 looked awesome in that bright red case and its big black paddles which inspired confidence not like those wimpy sticky pads.

And besides I grew up in the 90s when a certian alcoholic, nymphomaniac, prostitue loving lawyer with a man girdle and LP10 as co-host made us believe we could save people every Tuesday :D

You can order paddles for the life pack 12, then you can still look cool like they do on TV.

Oh and death is death, young or old. I've worked and lost newborns to people well over 100. When they die they die. Did what you can do move on no worries.

In your case only thing that should have bothered you is what to get for your next meal as soon as you met your ridiculous protocol of checking 3 leads on an obvious death.

Edited April 26, 2010 by spenac