To work a code or not

[Just Plain Ruff]

Yeah, I can't remember the last compassion code that I did was actually a true code. More of a long look, a check the pulse, a put the monitor on and really look at the baby. Did I start cpr, not that I can remember but cpr was usually already started.

My job isn't to save the baby at that time. The baby is already dead. My job is to work with the parents and help them through this immediate time. Work with them to prepare them for what is going to happen in the next hour to two.

That's my new job, parental support and familial support. And I have to say I'm pretty damn good at that. I do have a perspective that many medics do not.

[HarryM]

We never work an arrest if there are obvious signs of death. Generally almost never start a full resuscitation if initial rhythm is asystole. Of course there are exceptions, not a blanket rule.

Edited July 30, 2013 by HarryM

[runswithneedles]

So let me get this straight in my head. A compassion code may be beneficial since you are demonstrating to the family that everything is being done?

[island emt]

A compassion code is not going to make anyone feel better if the pt is dead before your your arrival with obvious signs such as lividity or rigor,

Are they cold ? or warm ? Are they cyanotic and have fixed pupils? Do they have a shockable rhythm on the monitor or AED ?

was the arrest witnessed and how long ago? greater than 5 minutes?

Was CPR started soon after arrest and continued until your arrival?

If the answer to any of the above is wrong , then don't work them.

We don't abuse corpses for the benefit of the family.

The family becomes your patients for you to care for

[Happiness]

About the old timer: My instructor ( now retired, shes way old ) did say to do CPR on babies no matter how dead, for the parents sake. and I think that makes sense, nothing much worse than losing your own child, very very sad indeed.

So how do you explain to the cops and medical examiners that you have destroyed evidence in an abuse case. In BC we do not work on codes that are obvious not viable. As for giving notification to the family, it truly is the best thing to do and they do appreciate it more than you think.

I do know that compassion codes play a part and I have also done one in 15 years. Dead is Dead and we can't fix it.

[Just Plain Ruff]

Goodness I hope I didn't make it sound like I'd work a baby if there was obvious signs of death.

But if CPR is in progress, I'll continue it until determined dead or ROSC based on our protocols and guidelines.

I never start a compassion code if there is obvious signs of death such as what Island stated.

And if it takes us more than 5 minutes to get to the scene and no cpr has been started, no code gets started if I can help it.

[Chief1C]

I have worked someone that had been down for a while. A long while, it took one hand to roll them to a board. The whole body moved with one tug. I'd say at least 8-10 hours. Cold, blue, blood pooled.

Why?

The patients son. Probably in his 40's, but mentally, like 5; and holding a rifle. He wasn't pointing it at us. He put it down, got in the ambo, and we transported to the funeral home where PD and a caregiver met us. We did do some CPR on scene, so he'd put it down..and it turned out to be an air rifle. But I wasn't looking to close. He had to get to the funeral home anyway, so we saved them whatever they would have charged to come get the body.

[Just Plain Ruff]

I have worked someone that had been down for a while. A long while, it took one hand to roll them to a board. The whole body moved with one tug. I'd say at least 8-10 hours. Cold, blue, blood pooled.

Why?

The patients son. Probably in his 40's, but mentally, like 5; and holding a rifle. He wasn't pointing it at us. He put it down, got in the ambo, and we transported to the funeral home where PD and a caregiver met us. We did do some CPR on scene, so he'd put it down..and it turned out to be an air rifle. But I wasn't looking to close. He had to get to the funeral home anyway, so we saved them whatever they would have charged to come get the body.

Holy shit batman, I think I would be doing CPR on that dude too.

[MariB]

I'd do a whole weekend at Bernie's if I had too

[Just Plain Ruff]

Minus Bernie if It got me to the hamptons