Why do we transport dead people?

[Just Plain Ruff]

Now we just need someone with Publishing experience,,,,,,,,hmmmmmm who might that be??????  that could put their experience behind this and give guidance?????

[Bernhard]

I'm glad we have the right to pronounce death on scene. Medics may decide due to "safe" signs of death, as rigor mortis, livor mortis and non survivable injuries plus asystolie. Working a code for some time with no effort (ROSC) is up to the emergency physician we then have available on scene.

As far as I know I never had ever worked someone who now shows an appallic syndrome. Either they died soon after or they survived. Secondary survival rate has dramaticallly increased with new CPR algorithms, in my starting years (end of 1980ies) this was more or less randomly. I at the moment recall just one patient before 2000, where the neighbour started CPR:this neighbour was a seasoned medic, his assisting daughter an experienced anaesthetics nurse, basic equipment available for them plus the ALS station and receiving hospital just a few minutes away. As I entered the room, the patient already was e.t.'d, we just had to attach ECG and provide defibrillations. Patient left hospital a week later, totally recovered. Since then I had a few saves, more and more since ~2000 when we started using AHA/ERC algorithms.

Actually, to answer the question in the topic, yes, I once transported a death person. Transporting bodies is ruled out in our states EMS law (and was back then, but it is time.barred anyway...here's the story:

We had a call in the church just neside the station. With service in full progress we CPR'd between all those praying people, somewhat scary (but not the first time for me, yes, they already talked about me to write a book). We moved into the ambulance, then pronounced dead after some while. Chaplain came into the ambulance and said a few words. Dispatch notified us about enhanced arrival time for the hearse car (sp?), so the supervisor, who was on scene in another role, felt the urge for a decision.

His first suggestion was to drop the body off in our station so we were available again. I talked him out of that.

The chaplain notified, that he had the keys for the local morgue, which happened to be just around the corner beside the cemetary. So the supervisor decided to take this opportunity...and we drove the body in our ALS ambulance slowly into the cemetary. Just as we arrived there, the hearse car arrived.

Disclaimer: things have changed since then, I never would do this anymore (meanwhile, I'm supervisor myself, maybe this call was one of the reasons), it was totally against the law, noone has ever found out and all went well. At least I learned (talked a bit with them), the burial services are quick enough to wait on-scene.

People are very pragmatic here - next time I'll tell the story about the other chaplain calling us, as he found out that the dead person wasn't medically cleared, up to his arrival...

To adresse another perspective mentioned here: After having some incidents I took a crisis intervention class to be trained to handle the relatives. Was an eye-opener! Never would like to work in crisis-intervention myself, but I use the skills to handle non-medical situations since then. I strongly suggest such a training to all young medics!

(BTW: have a happy new year, everyone!)

Edited January 1, 2016 by Bernhard

[Off Label]

Great story... I'd forgotten the time I had transported a body in my ambulance.... mid 1980's too...This gentleman was dying of some mysterious, non infectious (it turns out) process that some specialists at a major San Francisco university based medical center were very interested in finding out more about. His impending death would occur in a matter of days so arrangements were made to transport the body immediately after death, lights and sirens mind you, across the bay directly to said hospital's morgue for immediate autopsy. I kid you not. We got the call on a sunny Sunday morning, put him in the rig and off we went. Security let us into the morgue and we left him there on the stainless steel table with a drain in the middle of it in the midst of knives and ladles of all sizes hanging from their wall mounted racks.

Nobody was there to meet us and I doubt any exam was done on that body before it was lying there for a couple of hours. Unforgettable.

 

[Just Plain Ruff]

Great story... I'd forgotten the time I had transported a body in my ambulance.... mid 1980's too...This gentleman was dying of some mysterious, non infectious (it turns out) process that some specialists at a major San Francisco university based medical center were very interested in finding out more about. His impending death would occur in a matter of days so arrangements were made to transport the body immediately after death, lights and sirens mind you, across the bay directly to said hospital's morgue for immediate autopsy. I kid you not. We got the call on a sunny Sunday morning, put him in the rig and off we went. Security let us into the morgue and we left him there on the stainless steel table with a drain in the middle of it in the midst of knives and ladles of all sizes hanging from their wall mounted racks.

Nobody was there to meet us and I doubt any exam was done on that body before it was lying there for a couple of hours. Unforgettable.

 

damn, that's a crazy story.  I did clinicals where we would get calls from the local funeral home across the street from the EMS station and we would go over and help them move larger bodies and help them do all different sorts of tasks.  Sort of a public service for that funeral home.  

 

[ERDoc]

Sorry I haven't responded sooner, Ruff.  I would be more than happy to add some advice to your writing efforts.

[MEDCOM RADIO]

To call it or not to call it....That's the question: Feel free to call me selfish if you so desire but protocols not withstanding I've lost way too much sleep at night not so much for pronouncing what might not have been the best recommendation but having to tell family members on the scene that their loved one will no longer be with them for the rest of their days, those images will always haunt me until it's my time to be pronounced. EMS work can break your heart but a wise old medic once told me when I was ready to quit is that all that we experience minute by minute, hour by hour, day by day, week by week, month by month & year by year the truly unfortunate ones are the victims & their loved ones that experience sickness, injury & death just one time to forever alter their lives. I don't know if this in any ways satisfies your query but I just felt I needed to say my peace, thanks for reading.

[JTEMS]

In school I learned someone is not dead until they are warm and dead! I'm still in EMT school though, so I'm not the most qualified to answer.

[Off Label]

On ‎5‎/‎19‎/‎2016 at 7:18 PM, JTEMS said:

In school I learned someone is not dead until they are warm and dead! I'm still in EMT school though, so I'm not the most qualified to answer.

They're not dead until they're warmed after their therapeutic hypothermia!

[Just Plain Ruff]

5 hours ago, Off Label said:

They're not dead until they're warmed after their therapeutic hypothermia!

Unless you don't do that sort of thing and then they're just dead.  

[scubanurse]

On 5/19/2016 at 7:18 PM, JTEMS said:

In school I learned someone is not dead until they are warm and dead! I'm still in EMT school though, so I'm not the most qualified to answer.

True, I'm not talking about the extremes or rare cases here though.  I'm talking about the 80 year old who's spouse woke up and found them not breathing.

8 hours ago, Off Label said:

They're not dead until they're warmed after their therapeutic hypothermia!

This would indicate they got pulses back though, correct?  Therefore they would not be transporting a dead person.