# California Newborn Mistakenly Declared Dead



## VentMedic (Oct 8, 2007)

A tragic event for all involved, especially the baby.

http://www.emsresponder.com/article/article.jsp?siteSection=1&id=6305

*California Newborn Mistakenly Declared Dead*
Daniel Thigpen
The Record (Stockton, California)

Oct. 5--LODI -- Paramedics left a Lodi neighborhood before dawn Thursday convinced that the prematurely born boy they found floating in a toilet was dead.

But no one would realize the infant was miraculously alive until he reached the hospital moments later, where a nurse heard his faint cries from underneath the cloth covering him.

That glimmer of good news was quickly muted when medical workers soon discovered traces of methamphetamine and marijuana in the infant's blood.

http://www.emsresponder.com/article/article.jsp?siteSection=1&id=6305


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## BBFDMedic28 (Oct 8, 2007)

WOW. And that my friends is why we run ekgs b4 we pronounce anyone dead. and My local protocalls say always work babies.


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## princess (Oct 9, 2007)

A similar situation actually happened in my town several years ago...We responded to an unresponsive infant, and found the baby apneic and pulseless.  We are in a rural area - worked the kiddo (full ACLS) for the 20 minute or so trip to the hospital.  They continued coding for another 20 or so minutes and finally the doctor called it.  Several minutes later, a nurse began preparing the infant for her "last goodbyes" with her parents.  As she was pulling the tube, the baby gasped.  Needless to say, she was quite shaken up and called for the doctor.  The baby was found to have a pulse and was re-intubated d/t respiratory insufficiency.  She was transferred to a PICU ~ 2 hours from home and survived for another week before she became septic and died.


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## Airwaygoddess (Oct 9, 2007)

A hard and to say the least sad outcome and hard lesson learned.  I would be curious to know what the Co. protocal is for newborns found down like that.


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## Ridryder911 (Oct 9, 2007)

VentMedic;58242
[B said:
			
		

> California Newborn Mistakenly Declared Dead[/B]
> Daniel Thigpen
> That glimmer of good news was quickly muted when medical workers soon discovered traces of *methamphetamine* and marijuana in the infant's blood.
> 
> http://www.emsresponder.com/article/article.jsp?siteSection=1&id=6305



Can we tell why this possibly occurred? I also believe there is more than being stated here. Working an arrest based solely on the just the age is foolish and unethical as well. Personally, I do not always suggest EKG's on arrest as well. There are times patient will be in a PEA syndrome for hours before aystole, however; will never respond to any therapy. As well, there are such conditions as anacephalic infants that will survive hours before finally dying, and there is no chance of survival. 

Shame this occurred and personally could see where it would occur more. I hve seen multiple physicians call codes that "amazingly" came back to lige. 

R/r 911


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## BBFDMedic28 (Oct 9, 2007)

The EKG is to cover your ***. How do you argue your case in court based soley on "well the pulse wasnt there"? Working the arrest... wrong, not, or unethical SMOP says to do it. And foolish i disagree. Furthermore if there is a slight chance of life or a positive outcome, we should work it.


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## Ridryder911 (Oct 10, 2007)

BBFDMedic28 said:


> The EKG is to cover your ***. How do you argue your case in court based soley on "well the pulse wasnt there"? Working the arrest... wrong, not, or unethical SMOP says to do it. And foolish i disagree. Furthermore if there is a slight chance of life or a *positive outcome*, we should work it.




Do you really think an EKG is sufficient enough to CYA? Honestly..Been there done that. ECG's is only for those that cannot determine life or death.  If one is to declare someone dead.. (in general most states) recognize signs of incompatible with life (decapitation, major trauma), post mortem hemostasis or levity, putrification or decomposition. Now, does hospitals or even nursing homes require EKG's ? .... NO! The reason being is dead is dead. One should be able to detect death from absence of a carotid pulse * and * absence of an apical pulse. Period. 

The reason for the EKG, would be because of the gross error as above. If you attach them to a monitor, then you obviously do not meet the standard criteria to determine death, as well, now MUST take action if there is any indication, even though it is known to be futile. 

For those that "brain dead" the general rules are:  
Unresponsive, no pupillary responses, all brain function ceases, fail caloric test (cold water into ears, eyes moves toward the water), absent corneal reflex, dolls eyes, apneic, and ECG is terminal

Even the AHA and other recognized medical organizations understand medical futility. Unfortunately, EMS is again s-l-o-w to become educated in general care and medicine. 

Medical futility refers to treatment that's hopeless or interventions that aren't likely to benefit the patient even though they appear to be effective. For example a patient with a terminal illness who's expected to die with a cardiac arrest, or traumatic arrest. Cardiopulmonary resuscitation may be effective in restoring a heartbeat but may still be deemed futile because it doesn't change the patient's outcome.. thus the reason traumatic codes are not worked as well. 

Please read current literature, even in the BLS for health care providers manual. Field termination is being encouraged. As well, I recommend you as to attend or read the standard guidelines of as set out by the Neonatal Resuscitation Program per AHA & American Academy of Pediatrics  (of which I am instructor in) on their recommendations of terminating a pediatric arrest or even starting a code. Yes I definitely agree upon outcome bases... now, when stating that, look at the numbers. This is what outcome base means.

R/r 911


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## BBFDMedic28 (Oct 10, 2007)

Sufficient enough? by itself no. It helps prove your case. I uderstand that you are able to detect death by checking pulses and can document, but EKGs are just another source of proof. As far as obvious...I agree no EKG needed.


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## Emtgirl21 (Oct 11, 2007)

We are required to have a EKG strip with our report it we dont work a code or even if we do.


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