# How to cope



## sop (Apr 5, 2009)

How could you cope with something like this? : You get a call about a mother who says her baby is not breathing. When you get on scene and go into the house, you see an infant lying down in a bed in the bedroom with a blooded nose. You and your crew do everything you can to save the infant’s life, but nothing works. The infant is dead, and you have been elected to tell the parents that their child is dead. After you break the news, the parents go through the stages, and you have to leave the dead baby with the parents there at the scene. :sad:


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## Chimpie (Apr 5, 2009)

Did you notify the police?  And wait on scene till they got there?


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## HotelCo (Apr 5, 2009)

I'd want to know why a student was elected to tell the parents...


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## Ridryder911 (Apr 5, 2009)

There is so many things wrong with this scenario. First, if you are going to or have decided to work the infant most EMS will decide to transport. Very few have no ROSC protocols for infants, not saying it probably should not be considered.

Other things such as a "bloody nose" which maybe indications of a natural death or a form of a suspected child abuse. Alike what has previously posted, LEO should be notified no matter the situation.  

As well, I doubt one will see.... "_ the parents go through the stages"... _ as in the traditional stages of death. One may see the initial stage of grief such as anger, denial, etc.. The other is the blanket statement of ..._have to leave the dead baby with the parents there at the scene. ..."  _. This would be considered a crime scene until further evidence and alike all others, the body should not be disturbed. 

Personally, I cope with this just alike any other death. Shame it occurred but cannot become emotionally involved. I am empathetic, not sympathetic in the realm that I care for those involved but keep a clear head for my next patient. My next patient demands and needs for me to be totally attentive to their needs, I cannot if I am distracted by a previous call. 

Unfortunately, its just part of the job. No different in telling the spouse that had been married to their mate for 60 years that they have died. 

R/r 911


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## Ms.Medic (Apr 6, 2009)

HotelCo said:


> I'd want to know why a student was elected to tell the parents...



Umm, Im kinda curious too.


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## fortsmithman (Apr 6, 2009)

I'm also a student with my service.  What my service would is we would transport to hospital.  My service wouldn't tell the parents the baby was dead because we would be working on the baby till we got to the hospital.  The doctor or Coroner would make that notification.  I said Coroner because there are times not many but  there are time when there is no doctor in town.  Most of our doctors are only here on locum.  We may be getting a permanent doctor in a few months.  Most communities in the Northwest Territories only have a nursing stations with RNs and LPNs a few have NPs as well.


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## mycrofft (Apr 6, 2009)

*I think the poster just wants to discuss handling deaths.*

Pardon the crystal ball, SOP, but isn't your post about misgivings you have about your role on the scene of a death, particularly that of an infant?

More than likely you will either transport, or law enforcement ("LE") will take the body into their control. Either LE or the receiving medical facility will tell the parents.

As an EMT wanting "not to screw up" (we all get religion at some point, and the EMT's prayer is "Dear Whomever It Concerns, don't let me screw up!!"), you should be too busy trying to help the pt to worry about telling the parents. I'd worry more about parents who try to get too involved as a compensating mechanism, or who get angry. 

Everyone has a type or types of calls they are less emotionally able to handle. Use whatever resources you have if a call troubles you, including talking to your boss.


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## Ms.Medic (Apr 6, 2009)

sop said:


> How could you cope with something like this? : You get a call about a mother who says her baby is not breathing. When you get on scene and go into the house, you see an infant lying down in a bed in the bedroom with a blooded nose. You and your crew do everything you can to save the infant’s life, but nothing works. The infant is dead, and you have been elected to tell the parents that their child is dead. After you break the news, the parents go through the stages, and you have to leave the dead baby with the parents there at the scene. :sad:



Just out of curiosity, didnt you know or do some research on what this field was about before you became a student ? This is what happens, and some people cant cope, therefor they dont get into this field in the first place.


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## sop (Apr 6, 2009)

Yes, anytime you have a death such as that you call the police and wait for them to get there. You will have to answer questions. I’m not saying that I was involved on that call; I just wanted to know what to do if I was? What do you do, yourself, to clear your mind? It hit a nerve with one of the EMTs who just had a newborn (he’s alright now). What had happen on that incident was the mother had the baby sleeping in the same bed with her and she accidently rolled over on the baby while sleeping and killed it. I understand that this is a part of the job, and there are other people that need help. Something that would probably hit a nerve with me is if I knew someone personally. Id would have to live with that the rest of my life, not being around them anymore. But I’m not trying to wish that.


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## AJ Hidell (Apr 6, 2009)

I dunno... it's never been anything I had to "deal with".  I just go back to the station, get nekkid, and watch TV like after any other run, never giving it a second thought.  In fact, I've known very, very few medics in all these years who ever had any kind of problem with these kinds of scenarios.  But I did have one partner commit suicide over it too, so if it's not your cup of tea, get out now.


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## nomofica (Apr 6, 2009)

How do you deal with it if you let it get too personal?

-Talk about it with a therapist that your service *SHOULD* be supplying.

-Learn CIS (critical incident stress) management skills (which include the above option)

-Next time, don't think twice about it but rather: "it's a shame, but $hit happens and the world keeps turning".

Just my $0.02


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## flhtci01 (Apr 6, 2009)

sop said:


> After you break the news, the parents go through the stages, and you have to leave the dead baby with the parents there at the scene.



As the previous posters have said there are many things wrong with this scenario.  

How long was the scene time?  While people go through stages they do not 'click' from one to the next.  Everyone is different and a stage can take up to a couple of days or more or be skipped all together.  

If they get to the anger stage, you have to be aware of this and be able to protect yourself as they may direct their anger towards you.


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## trevor1189 (Apr 6, 2009)

Not sure why you would have left the baby with the parents. From what I have heard around here at least from an instructor who is also an EMT, even if there is obviously nothing that can be done for a baby or small child, load and go.

Gives the parents time to deal with the death and let them think everything was done that could be possibly done. Also the doctor at the hospital can inform the parents.

As for personally dealing with it, definitely talk to someone if it is really bothering you. Your dept should have CISM protocals.


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## Sasha (Apr 6, 2009)

> even if there is obviously nothing that can be done for a baby or small child, load and go.



Why? To jerk the parent's emotions around as if there's hope? 

Some systems strive to be medical providers, and not just a taxi ride to the hospital. As a medical provider it's your responsiblity to not give false hope to the parents. When nothing can be done, nothing can be done and adding an ambulance bill on top of a funeral bill won't do them any good.



> Gives the parents time to deal with the death



How? By roaring away lights and sirens with their little one in the back gives them hope that there's something that can be done. Why deal with a death when you have hope your child may survive? Happens all the time on TV, after all!


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## trevor1189 (Apr 6, 2009)

Sasha said:


> Why? To jerk the parent's emotions around as if there's hope?
> 
> Some systems strive to be medical providers, and not just a taxi ride to the hospital. As a medical provider it's your responsiblity to not give false hope to the parents. When nothing can be done, nothing can be done and adding an ambulance bill on top of a funeral bill won't do them any good.
> 
> ...


I don't think there is any parent who would want an EMT to walk in and say sorry they are dead there is nothing we can do. Again I am just saying something I have been told by one instructor and I don't think it's a bad idea.

I am not saying tell them everything is gonna be ok, but just tell them it doesn't look good but we are gonna do everything possible. If they called 911 for an ambulance they are going to be expecting some sort of help...

Also, around here lights and sirens are not used to transport the patient to the hospital the majority of the time.


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## Sasha (Apr 6, 2009)

trevor1189 said:


> I don't think there is any parent who would want an EMT to walk in and say sorry they are dead there is nothing we can do. Again I am just saying something I have been told by one instructor and I don't think it's a bad idea.
> 
> Also, around here lights and sirens are not used to transport the patient to the hospital the majority of the time.



I don't mean to sound disrespectful, but it's really best to wait until you're actually in class to make opinions like that.

A parent does not want their emotions toyed with. If the child is obviously dead, then the child is dead. No amount of show coding (I hate show codes.) is going to bring that back.


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## trevor1189 (Apr 6, 2009)

Sasha said:


> I don't mean to sound disrespectful, but it's really best to wait until you're actually in class to make opinions like that.
> 
> A parent does not want their emotions toyed with. If the child is obviously dead, then the child is dead. No amount of show coding (I hate show codes.) is going to bring that back.



I don't want to sound like an ***, but please don't tell me what to think or what opinions to have.

You may hate show codes and that is fine. I was just relaying information I have been told by an EMT who has been in the service for many years. You can do whatever you want. Please remember all ambulance services are different, your way isn't necessarily the standard.


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## Sasha (Apr 6, 2009)

trevor1189 said:


> I don't want to sound like an ***, but please don't tell me what to think or what opinions to have.
> 
> You may hate show codes and that is fine. I was just relaying information I have been told by an EMT who has been in the service for many years. You can do whatever you want. Please remember all ambulance services are different, your way isn't necessarily the standard.



You are informing people of how things are when you aren't even in class to be in the field yet, parroting what you heard from someone who may or may not be a good EMT. Long time in the field doesn't equal competence. 

And as I said, some ambulances services strive to be an extension of a hospital, not just a taxi ride to it, and actually expect their staff to behave like medical professionals, not taxi drivers.

Put yourself in the parents shoes. Your little two month old baby is found cold and rigid. Do you want the child to be whisked away from you in a screaming ambulance, giving you a false sense of hope, then to find out it was all hopeless, to be grieving for the second time, and to later be stuck with an extravagant ambulance/ER bill on top of funeral costs? 

Or would you rather be at home, with your child, having a chance to hold them one last time, to see them without an indent in their chest from CPR and tubes down their throat and lines coming out of their scalp making peace with what has happened and greiving?


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## trevor1189 (Apr 6, 2009)

Sasha said:


> You are informing people of how things are when you aren't even in class to be in the field yet, parroting what you heard from someone who may or may not be a good EMT. Long time in the field doesn't equal competence.
> 
> And as I said, some ambulances services strive to be an extension of a hospital, not just a taxi ride to it, and actually expect their staff to behave like medical professionals, not taxi drivers.



I am currently riding third member with a local ambulance service to get experience before school. So I do have some field experience.

I'm not sure why you have to dismiss everything I post. If you don't agree then fine. Post your opinion. That's why this is a forum. To get multiple ideas, not just yours.

People can see I am a student and if they choose not to listen to what I say on the forums then that is fine. But I have the same right to post here as you.


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## Sasha (Apr 6, 2009)

trevor1189 said:


> I am currently riding third member with a local ambulance service to get experience before school. So I do have some field experience.
> 
> I'm not sure why you have to dismiss everything I post. If you don't agree then fine. Post your opinion. That's why this is a forum. To get multiple ideas, not just yours.
> 
> People can see I am a student and if they choose not to listen to what I say on the forums then that is fine. But I have the same right to post here as you.



I never told you not to post, I simply said you may want to wait 'til you're in class and educated about the problem before forming an opinion on the matter. I don't go around having specific issues with anyone, if I see a post I don't agree with, I post in response. Be it you, or someone I've befriended from the site. I didn't discount you because you are a student, I just don't see how you can speak with expertise with having very limited experience and no education on the matter. I'm not saying you should only accept my idea, I'm presenting my idea. And I'm always very passionate about my opinions.


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## Ridryder911 (Apr 6, 2009)

trevor1189 said:


> Not sure why you would have left the baby with the parents. From what I have heard around here at least from an instructor *who is also an EMT[/B.*


* 

A couple of things. Wow! They have EMS instructors that are not EMT's? uhhh With that maybe not a good one.. either as an EMT or instructor. Obviously they have no real field experience informing students of such nonsense. First time I found out an EMT transported a dead kid just because.. they will find their arses fired. Justify to me, why you treated and transported other than maternal instincts? 



trevor1189 said:



			even if there is obviously nothing that can be done for a baby or small child, load and go. Gives the parents time to deal with the death and let them think everything was done that could be possibly done. Also the doctor at the hospital can inform the parents.

As for personally dealing with it, definitely talk to someone if it is really bothering you. Your dept should have CISM protocals.
		
Click to expand...


There is so many things wrong with those statements. Be a health care professional! Quit being unethical and just plain incompetent! 
So your piss poor sympathy has now increased anxiety that there maybe a ghost chance in hell that there is something to you attempting to resuscitate. Thanks to the oh caring one for costing the family grief to only be told how incompetent you were by the physician and then now to charge the family $1000 to $3,000 for an ambulance and ER bill! Giving families false hope and thoughts is not only cruel but unethical and negligence on being caring to the family. Guess what? It IS part of your job to inform when there is nothing left to do. Don't dump your dirty deeds onto the physician! 

CISM for a dead baby? Get real! CISM has proven to be more harmful unless from a licensed psychiatric professional and I doubt most EMS will cover since it is a part of your job… deal with it or get out. 
Ask your instructor if they are willing to pay for this type of behavior and treatment, since this what they are teaching you?*


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## trevor1189 (Apr 6, 2009)

Ridryder911 said:


> A couple of things. Wow! They have EMS instructors that are not EMT's? uhhh With that maybe not a good one.. either as an EMT or instructor. Obviously they have no real field experience informing students of such nonsense. First time I found out an EMT transported a dead kid just because.. they will find their arses fired. Justify to me, why you treated and transported other than maternal instincts?
> 
> 
> 
> ...


They were not teaching an EMT course. Just a basic first aid/cpr course. But they happened to be an EMT. As I'm sure you can read in my signature I have not started EMT class yet.


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## trevor1189 (Apr 6, 2009)

Sasha said:


> I never told you not to post, I simply said you may want to wait 'til you're in class and educated about the problem before forming an opinion on the matter. I don't go around having specific issues with anyone, if I see a post I don't agree with, I post in response. Be it you, or someone I've befriended from the site. I didn't discount you because you are a student, I just don't see how you can speak with expertise with having very limited experience and no education on the matter. I'm not saying you should only accept my idea, I'm presenting my idea. And I'm always very passionate about my opinions.



I never claimed to have expertise. It clearly states that I am a student under my user name. I am simply expressing my opinion.


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## reaper (Apr 6, 2009)

That is what they are trying to say. Do not listen to every EMT that tells you something. They may be a crappy provider and teaching you the wrong way.

If you get to a scene where the child is obviously been down for a while. Take the parents in the room, explain to them that it is too late to do anything, show them empathy and compassion. let them be with their child while you wait (unless the death is suspicious).

That is the way you deal with it. You do not scoop and run, giving the parents false hope and added grief!


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## Ms.Medic (Apr 6, 2009)

trevor1189 said:


> I never claimed to have expertise. It clearly states that I am a student under my user name. I am simply expressing my opinion.



In my *OPINION*, your _*OPINION*_ is just plain insane !!!  There is no way in the world that I have ever heard of anyone doing what you are talking about. I am a mother of 2, one which was born at 24 weeks, came home on a monitor because he stopped breathing, and his heart stopped quite a bit. If something were to happen to him, in NO WAY would I want the paramedics to try anything on him. Tell me peacefully, without violating my child anymore, and let me hold him until the JP/funeral home gets there. Dont send me into a frinzzy trying to drive to the hospital to "see him for one more minute before he _*dies*_". Thats crazy for you to think thats okay. AND thats MY opinion.


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## Ridryder911 (Apr 6, 2009)

trevor1189 said:


> I never claimed to have expertise. It clearly states that I am a student under my user name. I am simply expressing my opinion.



Sorry, but your avator has an EMT patch on it. Student can mean anything from EMT student to Paramedic to Physician. 

Opinions are fine, as long as one can justify their thought process. Hopefully, you will be taught differently by more qualified personnel. Just being EMT does not impress me or others as the course itself is far lacking. 

Good luck, and hopefully you will understand our professional views as I see this type of scenario on a weekly basis from EMS to as a RN in a ER. We tend to see the "whole" picture and there is nothing more disheartning than telling family members that the EMT's should had never started anything. This only points out the flaws but causes hardships. p.s. many of the physicians do not tell the family, it maybe the nurses or Chaplains. 

R/r 911


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## fortsmithman (Apr 6, 2009)

My service would transport the babys body because we are also responsible for body transport.


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## trevor1189 (Apr 6, 2009)

Ridryder911 said:


> Sorry, but your avator has an EMT patch on it. Student can mean anything from EMT student to Paramedic to Physician.
> 
> Opinions are fine, as long as one can justify their thought process. Hopefully, you will be taught differently by more qualified personnel. Just being EMT does not impress me or others as the course itself is far lacking.
> 
> ...


Sorry for the confusion about the student status then. I will fix that.

I definitely agree about the EMT course lacking. I have seen some EMTs that scare me with their lack of knowledge of the human body and how it works.

I am currently trying to take as many con ed classes as I can to educate myself better. It's funny because when they ask for my emt cert number so I get credit and I tell them that I am not an EMT yet, just came to further my education. They seem all confused and wonder why I am "wasting" my time taking classes I don't get credit for. I guess they don't realize that even without credit there is stuff to always be learned.


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## exodus (Apr 6, 2009)

Here, we are supposed to work and transport all PD / FF / Medic fallen in line of duty other than obviously dead criteria. Even if they are obviously dead, we can still work them if there are large crowds, etc.  This is primarly to prevent public outcry and the city picks up the bill.


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## EMTinNEPA (Apr 6, 2009)

fortsmithman said:


> My service would transport the babys body because we are also responsible for body transport.



Ditto.

You know a thread is screwed up when I feel that _I_ have to be the voice of reason.  A few points...

Trevor...

Yes, you are an EMT student.  Yes, you have a right to your opinion.  The people here also have the right to not take your opinion seriously _because_ of your status as an EMT student with minimal field experience.  Get used to it.  Until your years in this field have reached double digits, there will always be _somebody_ out there who will talk down on you because of a lack of experience or education.  And even if you _do_ have 10, 15, 20, hell, 30 years of field experience, there will always be some intern or resident who will treat you like a moron because of "lack of education".  Get used to it.  We are the middle men of medicine.  As an EMT, the public will think you have more skills than you do and your superiors (nurses, physicians, etc.) will think you have less skills than you do.  It happens.  Somebody will always talk down on you because of your status.  Now, you still have a right to your opinion, even if few on here will take it seriously.

Other people...

I can't say what I would want if I were the parent of a baby who stopped breathing because I've never been a parent.  Some parents may want transport, even though they know there is nothing that can be done.  It may ease their minds to know that everything that could possibly be done was done.  Again, it's _possible_.  Also, while I don't necessarily disagree with your opinions, sometimes some of you tend to come off as condescending.

Personally, I would do what the parents wanted.  If the baby wasn't showing any signs of obvious death (lividity, rigor, etc.) I would work it.  If the baby was showing obvious signs of death (lividity, rigor, etc.), I would tell them that all resuscitation efforts would most likely be futile.  But I would give them the choice.  If they chose to have nothing done, I would be a grief mop until PD and/or the coroner got there.  If they chose to have the baby worked, I would keep them updated.  And I would be honest with them.  If our efforts were doing nothing, I would tell them, and if at any time they wanted to terminate efforts, I would call medical command and get permission to call it.  If they wanted the baby transported, I would transport... NON-EMERGENT.  No reason to risk our lives for a dead baby.

I only skimmed the thread, but did anybody here mention giving the parents a choice?

To the OP...

As for dealing with tragedy, I just block it out.  Do what's in your job description.  But do not get attached.  Do not become emotionally involved.  It will destroy you.  Like in this instance, you would have to tell the parents that there was nothing you could do.  You would get the coroner or PD on scene, maybe be questioned by PD, and you would go right back to work.  Do you think anybody else who was in that room would be going back to work anytime soon?  The bottom line is that you're doing a job.  Care about what you're paid to care about.  Worry about what you're paid to worry about.  But once you get back to the station or once you get home for the night, ignore it.  My solution is just not to care beyond what I'm required to.  There are many who will disagree with that, but it's how I cope.  It may sound harsh or callous or (insert your negative descriptive term here), but it's one way to get by.

And I'll stop now, because I think I just set the record for my longest post ever.


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## trevor1189 (Apr 6, 2009)

EMTinNEPA said:


> Ditto.
> 
> You know a thread is screwed up when I feel that _I_ have to be the voice of reason.  A few points...
> 
> ...


Thank you for your support. Definitely something to consider, parents requests. If a parent asked for resuscitation efforts then I would absolutely do a "show" code. I am not a parent, but I can only imagine what they would be going through and as an average person not in EMS, I would want them to try to do everything they can.


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## Ridryder911 (Apr 6, 2009)

Sorry, but you guys are badly mistaken. The parent do *NOT* have a choice as all dead bodies are presumed homicide until otherwise determined. A few hours discussing this with your superiors and the District Attorney will change your mind as they may attempt filing charges against you. 

You made the determination they were dead, then there is either obvious signs or not. It is not a guessing game or "hey; what do you want us to do?".. duh? .. 

You are supposed to know either to effectively perform resuscitation on a infant that has the possibility to respond or not. If not, you should had called it. This is NOT a game nor a drama conquest. 

Most officers after finding out it is an DOA may not even allow medics within the room, no matter who you think you are. 

Be careful of what you say and what you do. Your actions and words have a lifetime consequences. 

For those that would do a "show code" I will be willing to testify against you for free in unethical and possibly emotional distraught to the parents. You should be removed from the health field for the pain and suffering of presenting an unrealistic outcome to the family. You are cruel and inhumane and just admitted you do not know how to do this job accurately! This is *NOT TV * we are not actors! We perform resuscitation because we may resuscitate the infant, nothing else!
R/r 911


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## reaper (Apr 6, 2009)

:beerchug: Bravo :beerchug:


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## AJ Hidell (Apr 7, 2009)

Ridryder911 said:


> Sorry, but your avator has an EMT patch on it. Student can mean anything from EMT student to Paramedic to Physician.


I'm not big on draconian forum rules, but I really wish we could get one on the rampant misrepresentation going on here.  If you are not legally entitled to use a title or wear an emblem, you shouldn't be posting it with your name.  It's not cute.  It's not funny.  It doesn't make us admire your goals.  It's just dishonest and misleading, and loses you major respect points.


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## Ridryder911 (Apr 7, 2009)

After reading my last post's I am going to have to quit posting per phone.. apologize for the grammar. It sucked. 

R/r 911


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## Sasha (Apr 7, 2009)

Ridryder911 said:


> After reading my last post's I am going to have to quit posting per phone.. apologize for the grammar. It sucked.
> 
> R/r 911



Wow, that was a phone post? Ten times better than any of my phone posts. 

Bad grammar and spelling mistakes is part of the creative writing process


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## trevor1189 (Apr 7, 2009)

AJ Hidell said:


> I'm not big on draconian forum rules, but I really wish we could get one on the rampant misrepresentation going on here.  If you are not legally entitled to use a title or wear an emblem, you shouldn't be posting it with your name.  It's not cute.  It's not funny.  It doesn't make us admire your goals.  It's just dishonest and misleading, and loses you major respect points.


Sorry to hear that. I really was looking for your respect. -_-

You know Paramedic students wear a paramedic patch with student underneith it. That is how my profile is setup. Also in my signature it clearly states my level of education and future plans.

If you can't take the time to read it, that's not really my fault. It's an internet forum, not like I go around wearing one in real life.

You need to loosen up a bit, it's just an avatar. If it bothers you that much, you may add me to your ignore list and then you don't even have to look at. I really won't mind.


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## EMTinNEPA (Apr 7, 2009)

Ridryder911 said:


> Sorry, but you guys are badly mistaken. The parent do *NOT* have a choice as all dead bodies are presumed homicide until otherwise determined. A few hours discussing this with your superiors and the District Attorney will change your mind as they may attempt filing charges against you.
> 
> You made the determination they were dead, then there is either obvious signs or not. It is not a guessing game or "hey; what do you want us to do?".. duh? ..
> 
> ...



If you thought I said anything remotely close to anything resembling a "guessing game", then you need to reread my post and stop being condescending just because you can.  Did I ever say this was a game?  Or a drama request?

On DOAs around here, we are _required_ to stay with the body until the coroner arrives.  That goes for all bodies.  And yes, I have had this confirmed by my superiors.

And as for testifying against me for doing a "show code" and giving false hope, maybe I need to elaborate a bit more on what I would say to the parents.  It would probably go something along the lines of "Sorry, your kid is dead, but if you want us to do CPR just so you can rest your poor little heads, sure, why the hell not?", except perhaps not as blunt.

As for _all_ dead bodies being presumed homicide until otherwise determined, I doubt it.  I also doubt that the officers would charge EMS personnel with anything, because there was a call in my area similar to the one the OP described.  Infant, pulseless, apneic, unknown downtime, blood in the airway, rigor starting to set in, etc.  Not only did EMS work it, but they got a _police escort_ to the hospital.  Something tells me that officer won't charge them with anything.  So, before you try to tell me that I am unfit to be in my profession, answer one question: are you ready to speak for ALL EMS personnel and ALL LEOs in the entire country?


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## EMTinNEPA (Apr 7, 2009)

Besides, wasn't this thread about _coping_?


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## Ridryder911 (Apr 7, 2009)

EMTinNEPA said:


> If you thought I said anything remotely close to anything resembling a "guessing game", then you need to reread my post and stop being condescending just because you can.  Did I ever say this was a game?  Or a drama request?
> 
> On DOAs around here, we are _required_ to stay with the body until the coroner arrives.  That goes for all bodies.  And yes, I have had this confirmed by my superiors.
> 
> ...




You obviously don't know real life yet! You have a dead body; it is a crime scene until otherwise proven. Yes, I have seen bull headed medics be placed into cuffs. Wait until they have a child abuse case that was mistaken for SIDS, and then see how things will occur. So the Police gave you an escort.. Great! Now you admitted your crew now has placed more than themselves in danger; when it should had never occurred to begin with! 

Why would anyone with any brain matter that pretends to have any medical or knowledge ask the family...? What would you like me to do? How do you think they would respond? DUH!  If you have to ask the family "what would like us to do?" Then you sure hell don’t need to be there! Apparently, anyone that would ask a grieving family such a question is incompetent. Prove me wrong. 

Do they not teach your medics, rigor setting in = dead? Geez.. Did they ever take an AHA Healthcare Provider CPR there? How unethical and inconsiderate your guys were. Are they that ignorant or just lacked cerebral perfusion? Thank you EMS for asking what to do (knowing all along the efforts were futile) and now creating thousands of dollars of charges; all because you did not know how to determine death! 

Let me ask you, would they done the same if it was an adult? If not then they are performing age discrimination as well! 

Sorry, but you hit a raw nerve as I have seen too many "life savers" that did not have the integrity to be able to call a dead child dead because "they" were uncomfortable. Sorry,the emergency is not about them nor their feelings. Be a medical professional, more than that do your job! 

Inform the family it is too late, close the door, secure the scene until LEO arrives and ask only pertinent and direct questions without any accusations or emphasis. Attempt to comfort the family within reasons and empathy. They are your patient, be professional and the family will defintely far resect you more than to later find out that you only were only performing a "show" code. 

R/r 911


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## EMTinNEPA (Apr 7, 2009)

Ridryder911 said:


> You obviously don't know real life yet! You have a dead body; it is a crime scene until otherwise proven. Yes, I have seen bull headed medics be placed into cuffs. Wait until they have a child abuse case that was mistaken for SIDS, and then see how things will occur. So the Police gave you an escort.. Great! Now you admitted your crew now has placed more than themselves in danger; when it should had never occurred to begin with!
> 
> Why would anyone with any brain matter that pretends to have any medical or knowledge ask the family...? What would you like me to do? How do you think they would respond? DUH!  If you have to ask the family "what would like us to do?" Then you sure hell don’t need to be there! Apparently, anyone that would ask a grieving family such a question is incompetent. Prove me wrong.
> 
> ...



First off, I wasn't even _on_ the call, so the police didn't give _me_ anything.

Gee, I guess when you're as old as you, it's easy to win an argument by saying "you don't know real life yet".  I know what rigor is.  I know rigor = it's too late.  Maybe the family wants everything possible done for _their_ peace of mind.  Ever think of that?

And how can I prove or disprove competency based on _your_ opinion?  You wouldn't work it so that means nobody should work it.  You can't prove or disprove an opinion.

As for medics getting hauled off in hand-cuffs, you are supporting such a thing, right?  Weren't you _just_ complaining about badge-toting blowhards a week ago?  So it's ok to take a medic to jail for trying to set a grieving family's mind at ease, but a reckless driver gets off just because he has a dying relative?

Yes, they would have done the same if it were an adult.  Every code I've ever worked where PD was on scene, they not only escorted us to the hospital, but helped us code the patient as well.  So no, no age discrimination.

As for EMS workers who would not call a dying child just because it would "bother" them, you _have_ interacted with me on here before, right?  I've had people try to stage an intervention over how detached I am.  I'd call that baby in a heartbeat.

As for _my_ actions, I believe what we have here is failure to communicate.  Here is what I would say, in this hypothetical situation as my mind formulates it right now.  "Mr. and Mrs. So-and-so, I'm sorry, but there is nothing we can do for your child.  They've been down for too long and the odds of us getting them back are non-existent.  All efforts to resuscitate your child at this point would be futile.  Is there anything you would like us to do?"  None of this "don't know how to determine death, dur, what do you want us to do?!? Oh noes, I don't know!!" crap you keep failing at throwing out, so how about instead of a strawman argument, you address what I'm _actually_ saying?  It's a novel concept, I know, but, call me crazy, the discussion tends to go much more smoothly if everybody tries it out.


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## Ridryder911 (Apr 7, 2009)

EMTinNEPA said:


> First off, I wasn't even _on_ the call, so the police didn't give _me_ anything.
> 
> Gee, I guess when you're as old as you, it's easy to win an argument by saying "you don't know real life yet".  I know what rigor is.  I know rigor = it's too late.  Maybe the family wants everything possible done for _their_ peace of mind.  Ever think of that?
> 
> ...



Here's a simple solution. Someone needs to educate those medics what death is or better yet remove them from action. Performing or even attempting resuscitation on someone that has early signs of *rigor mortis * or putrification demonstrates gross incompetency. There is NO excuse and quit trying to justify stupidity. 

Will your company pay for the medical expenses as it should; because of their incompetency?

In regards to Police I said.."bull headed medics" as in obviously stupid not knowing the proper thing to do and now I ask; Why Police escorts? 

So you are saying, they'll work about anything then?... Or should I ask; when do they not attempt to resuscitate someone? Especially if  signs of rigor is not proof enough?


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## EMTinNEPA (Apr 7, 2009)

I might as well be talking to a brick wall.  Fine, Rid, _you're right_.  Happy now?

[/my involvement with this thread]


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## exodus (Apr 7, 2009)

I'm trying to figure out why anyone would tx or even touch an obviously dead verifiable death...

By obviously dead:
Decapitation
Evisceration of heart or brain
Incineration
Rigor Mortis
Decomp


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## Ridryder911 (Apr 7, 2009)

EMTinNEPA said:


> I might as well be talking to a brick wall.  Fine, Rid, _you're right_.  Happy now?
> 
> [/my involvement with this thread]



Not really. Rather nauseous that we have this caliber of so acclaimed "medics". It is sad, sad statement we have such acclaims to be medically trained that not only admit of doing such but not even recognize the harm both emotionally but financially. Can one imagine an hospital calling a code on a person that had early signs of rigor mortis.. and then admitted that they were only "doing it" because they had asked the family; what would they like for them to do? .. Then charge or diffuse it by acclaiming they did not want to cause discomfort? .. it is the exact same thing in the prehospital environment. 

There is no brick wall. There is being obviously wrong and detrimental and then there is being human and making an error. 




exodus said:


> I'm trying to figure out why anyone would tx or even touch an obviously dead verifiable death...
> 
> By obviously dead:
> Decapitation
> ...



You too? 

R/r 911


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## Aidey (Apr 7, 2009)

sop said:


> How could you cope with something like this? : You get a call about a mother who says her baby is not breathing. When you get on scene and go into the house, you see an infant lying down in a bed in the bedroom with a blooded nose. You and your crew do everything you can to save the infant’s life, but nothing works. The infant is dead, and you have been elected to tell the parents that their child is dead. After you break the news, the parents go through the stages, and you have to leave the dead baby with the parents there at the scene. :sad:




How else have you dealt with stressful situations that have happened in your life? None of us will be able to tell you what will work best for you because different people cope with things differently. Some people exercise, some people ride roller coasters, some people drink (bad bad bad idea), some people volunteer in a homeless shelter, or they go to church, or they talk to a counselor. 

There are a multitude of different methods, and if you aren't sure what to do talk to a supervisor in your company, a mentor, a priest/pastor/rabbi/whatever. 

It's not unusual for people to have a hard time dealing with their first couple of codes. Once you do learn to deal with it, it does get a lot easier. Just because you have a hard time with a code doesn't mean you are unfit to ever treat another patient again, it just means you are human. 

Issues arise if you consistently can not deal with codes, or can't find a way to deal with the emotions. If no matter what you do you just can't stop thinking about it, then maybe this isn't the best field for you.


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## Veneficus (Apr 7, 2009)

exodus said:


> I'm trying to figure out why anyone would tx or even touch an obviously dead verifiable death...
> 
> By obviously dead:
> Decapitation
> ...



Simple,

lack of desire to take personal responsibility for decisions and not wanting to fulfill any of the difficult job requirements of medicine like telling family members that nothing can be done.

We could count for days the ways a majority of EMS providers want to do as little as possible, from education to personal responsibility.


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## AJ Hidell (Apr 7, 2009)

EMTinNEPA said:


> Maybe the family wants everything possible done for _their_ peace of mind.  Ever think of that?


Ever watch EMS run a code on someone you love?

I can assure you that it is not comforting, and offers no peace of mind.


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## Aidey (Apr 7, 2009)

For you maybe AJ, but can you speak for everyone in the world? No. 

I've watched the hospital code someone I knew and cared about, and in the long run I was glad they did it. She didn't survive, but the fact that they tried was worth a lot. 

If a family, or a lawyer, ever asks me "Did you do everything that you could" I like to be able to answer "yes" truthfully.


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## AJ Hidell (Apr 7, 2009)

Aidey said:


> For you maybe AJ, but can you speak for everyone in the world? No.


But statistically, which is more likely to offer them comfort?  I believe that studies have shown that families are more comforted by finality than by the false hope of a traumatic resuscitative event, and the person being whisked away to never be seen alive again.  Then, of course, there is the fact that they are now going to be driving themselves to the ER in a state of mind that they should not be driving, creating an unnecessary danger to themselves and other drivers.  Plus the fact that you are doing the same thing in the ambulance.  There is no benefit analysis that can justify this practice.



> I've watched the hospital code someone I knew and cared about, and in the long run I was glad they did it. She didn't survive, but the fact that they tried was worth a lot.


Hospital code is a completely different thing on multiple levels. 



> If a family, or a lawyer, ever asks me "Did you do everything that you could" I like to be able to answer "yes" truthfully.


If a lawyer asks you if you can justify what you did with the medical and scientific evidence, you'll have to truthfully answer "no, I just did it because I thought it might make the family feel better".  And they can make a good case that you did it only for financial reasons.


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## Aidey (Apr 7, 2009)

Statistically, I bet you have no better idea than anyone else here. I bet I could also find studies contradicting your studies. People's reactions to death are such a variable thing that I don't think anyone will be able to conclusively prove what the majority of anyone wants. Especially considering cultural and religious differences. 

Why? They didn't do or give her any medications the medics in the field couldn't have. In fact, if they hospital hadn't of been visible from the facility they probably would have continued to work it on scene. 

Will I? What makes you think I would have done anything that went against medical and scientific evidence?


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## Veneficus (Apr 7, 2009)

*without passion or prejudice*

Passion:

–noun 1. any powerful or compelling emotion or feeling, as love or hate. 
2. strong amorous feeling or desire; love; ardor. 
3. strong sexual desire; lust. 
4. an instance or experience of strong love or sexual desire. 
5. a person toward whom one feels strong love or sexual desire. 
6. a strong or extravagant fondness, enthusiasm, or desire for anything: a passion for music.  
7. the object of such a fondness or desire: Accuracy became a passion with him.  
8. an outburst of strong emotion or feeling: He suddenly broke into a passion of bitter words.  
9. violent anger. 
10. the state of being acted upon or affected by something external, esp. something alien to one's nature or one's customary behavior (contrasted with action ). 


prejudice:

–noun 1. an unfavorable opinion or feeling formed beforehand or without knowledge, thought, or reason. 
2. any preconceived opinion or feeling, either favorable or unfavorable. 
3. unreasonable feelings, opinions, or attitudes, esp. of a hostile nature, regarding a racial, religious, or national group. 
4. such attitudes considered collectively: The war against prejudice is never-ending.  
5. damage or injury; detriment: a law that operated to the prejudice of the majority.  

–verb (used with object) 6. to affect with a prejudice, either favorable or unfavorable: His honesty and sincerity prejudiced us in his favor.  

—Idiom7. without prejudice, Law. without dismissing, damaging, or otherwise affecting a legal interest or demand. 


The reason people solicit the aid of medical providers of all levels is for unbiased knowledge which they often do not possess or are not capable of acting with in a time of stress. Rather than argue, please be encouraged to be a professional and knowledgable provider. An emergency or health crisis is not the time to act based on emotions, real or perceived. Part of the responsibility of any medical provider is to act within the best interests of those seeking their aid. There is a big picture which always must be considered. Money is unfortunately part of that picture. 

How much piece of mind do you think it will bring a family when they go bankrupt from a futile resuscitation? A couple days in the ICU could run 10's of thousands of dollars. (prior to a funeral expense) 

If you don't know the potential costs, it is very important you find out.

I agree with Rid in this case. If death is too much for you to handle, you are not cut out for this work. If you truly care about people, please put aside your own desires for their benefit and step down.

If you really want to be a medical professional, please take the time to educate yourself on the more unpleasant aspects, as well as temper your emotions so that you can better serve your patients.

"I want to say I did everything possible."

This job is not about your wants.


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## ffemt8978 (Apr 7, 2009)

How about we get back on the topic of how to cope with the scenario, and not preach protocols, ethics, and legalities?  If you want to discuss those items, start your own thread.


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## CAOX3 (Apr 8, 2009)

Why does everyone think the rules change when a child is involved?  

Would you think of working an obviously dead 75 yo?  Children die, yes it sucks.  But it happens.

As far as coping with these instances, most people will never realize their having an issue with it till its to late.  Thats why strong relationships are needed to recognize when someone is in trouble.


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## trevor1189 (Apr 8, 2009)

CAOX3 said:


> Why does everyone think the rules change when a child is involved?
> 
> Would you think of working an obviously dead 75 yo?  Children die, yes it sucks.  But it happens.
> 
> As far as coping with these instances, most people will never realize their having an issue with it till its to late.  Thats why strong relationships are needed to recognize when someone is in trouble.



Because a child hasn't had a chance to have a full life. Therefore I think a lot of people will try to go above and beyond.


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## Sasha (Apr 8, 2009)

Every patient deserves your best. 8 months or 80 years, it's not your place to decide who hasn't lived life enough yet. If you have the ability to go "above and beyond" your norm, then you are not doing your best on every call.


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## trevor1189 (Apr 8, 2009)

Sasha said:


> Every patient deserves your best. 8 months or 80 years, it's not your place to decide who hasn't lived life enough yet. If you have the ability to go "above and beyond" your norm, then you are not doing your best on every call.



Has nothing to do with not giving your best on every call. Children are more resilient than the elderly and are more likely to have a better recovery from a longer down time than someone who is 80.


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## Katie Elaine (Apr 8, 2009)

trevor1189 said:


> Because a child hasn't had a chance to have a full life. Therefore I think a lot of people will try to go above and beyond.




Whether or not I would work the pediatric patient in this situation depends entirely on the instance, but if the same circumstances surrounded a geriatric patient, I would do the same thing. If rigor is setting in, or any other signs of obvious death/injuries incompatible with life are apparent, I would not work the patient. I would call a paramedic/someone qualified to pronounce, and I would have them call it. And until they arrived, I would explain to the parents the reasoning behind my call and why I wouldn't work the child, as well as let them hold the child, say their goodbyes, etc. But, if I had ANY reason at all to think the child was alive might have a chance, I would work it. 

But to answer the OP's question on how to cope, everyone copes differently. I'm sure any death in the field would be tough to deal with the first time, but that's one of the downsides of working in EMS. You win some, you lose some, and you just need to get on. Something such as SIDS (which is what I'm assuming the case is after reading the original post), is something that you will need to deal with on your own. I can understand after a traumatic incident you might need to have a CISM meeting with a professional, but thats about the only case. While being compassionate with patients, you need to have a certain apathy when it comes to dealing with death.


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## CAOX3 (Apr 8, 2009)

trevor1189 said:


> Has nothing to do with not giving your best on every call. Children are more resilient than the elderly and are more likely to have a better recovery from a longer down time than someone who is 80.




Actually adults respond far better to resucitative measures then children do.

Nobody responds from long down times.


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## Ridryder911 (Apr 8, 2009)

ffemt8978 said:


> How about we get back on the topic of how to cope with the scenario, and not preach protocols, ethics, and legalities?  If you want to discuss those items, start your own thread.



Actually, it is on topic. It is called ineffective or having poor coping mechanisms. Medics love to spout off ..."who has the right to decide, or younger have a better chance, or what would you want done?"... All of this are well intentions but truthfully is irrelevant and just attempting again to justify our actions; when indeed they maybe inappropriate and most have not a clue of what is real facts.

Yes, we are human and thank goodness we have have feelings. However, there comes times to make decisions and yes sometimes these have to be made instantly and correctly without emotions (especially by the health providers). Patients and even families expect us to make good sound judgements. These judgements should come from education, clinical experience. It is unfortunate that EMS programs lack the required education to truly educate death & dying and now it is apperantly upon how to determine when resuscitation measures should never be instituted and how to deal with it. 

Yes, making such decisions are hard. No one ever said it was not; but it is not our place to not be biased based upon our emotions. Our judgements have to way merit upon good sound clinical judgement not our emotions. There is much difference from empathy and sympathy. Yes, every patient deserves your best and sometimes that means you do nothing and the role of the patient changes to the immediate family or loved ones. 

I have written thesis and studied in-depth on families viewing resuscitation measures on children for ENA citation for such. Yes, it is true that families accept death easier but there is much difference though in measures that should had been instituted and those that should had never occurred. It is our role to know these in detail and to follow upon these, no matter what our personal feelings are. We as well need to study and investigate what our actions may cause by doing inappropriate measures or statements. 

It is during this emotional and delicate time that inappropriate statements or actions may have long lasting effects upon the survivors. To only find out that later that medical personal knew and willingly performed heroic acts because of their emotions not only can be devastating but costly both to the family and potentially to the rescuer. 

There are well written standards for such events. These standards were not developed over night nor not studied in depth without clinical trials. It would be nice to be able to say ethics and legal persuasion should not be considered but it would be wrong. It is not we should be emotionless but to develop critical thinking skills and use proven scientific medical standards as our basis for treatment or even not to treat. By using your emotions for basis of your treatment is practicing medicine upon your self & not the given prescribed guidelines.  

Medics need to learn coping skills. Realization that heroic efforts can actually be detrimental, that quality of life is just as important as having a save. Other factors such as long term treatment for the patient, increased disease process, acceptability for other illnesses not limiting the emotional and financial distraught that will be placed upon the family. All of this that can be brought upon by the actions of the EMT. Yes, a lot of weight and power for person of a 150 hour course. Again, actions should be followed by good sound clinical medical judgement. 

R/r 911


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## Sasha (Apr 8, 2009)

trevor1189 said:


> Has nothing to do with not giving your best on every call. Children are more resilient than the elderly and are more likely to have a better recovery from a longer down time than someone who is 80.



Actually, the elderly survive cardiac arrest a lot better than pediatrics who arrest. It's a myth that the younger you are the better your chances.


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## Katie Elaine (Apr 8, 2009)

trevor1189 said:


> Has nothing to do with not giving your best on every call. Children are more resilient than the elderly and are more likely to have a better recovery from a longer down time than someone who is 80.




I think what you are thinking of is compensation. I quote from an Intermediate that I work with, 'kids compensate then fall of the face of the earth.' 

Children can hold on better after facing a traumatic event, and they compensate better when losing blood, but in the end everything catches up to them and they need to be worked just as hard as any other patient. Just because they are young doesn't give them a free ticket out. They compensate, and by the time they begin to go downhill, it's too late


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## AJ Hidell (Apr 8, 2009)

Sasha said:


> Actually, the elderly survive cardiac arrest a lot better than pediatrics who arrest. It's a myth that the younger you are the better your chances.


Exactly.  And this is one of the factors contributing to the push to eliminate pedi intubation from the field.  Too many medics getting too emotionally charged and doing things that are not indicated, and that they are too freaked out to perform competently.


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## rhan101277 (Apr 9, 2009)

Deleted due to sleepiness.


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## VentMedic (Apr 9, 2009)

sop said:


> Something that would probably hit a nerve with me is if I knew someone personally. Id would have to live with that the rest of my life, not being around them anymore. But I’m not trying to wish that.


 
You also want to be a FF. You do realize you may be doing body recovery in the wrecked cars and burned homes of the people in your community, some of whom you may know. Some will also be children.


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## bensley101 (Apr 11, 2009)

I was reading through this whole post and someone stated that adding an ambu bill to funeral costs was a bad thing......glad I'm volunteer! lol, that way I don't have to think about doing that to anyone. Fortunately for them my services are free. 

I wonder if former pts give the best donations? probably not.


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