# Ethics? Allowed?



## Amelia (Feb 12, 2015)

You roll up on a call for a cardiac arrest. Once you get there you see obvious signs of death. Wife in denial or distraught as anyone would be. A) do you leave the area to inform MD of the situation or stay with deceased patient? B) Wife reaches for a comforting hug- youre allowed right? Id want a hug if my husband just died in front of me! 

Thanks!


----------



## DesertMedic66 (Feb 12, 2015)

Obvious signs of death means I do not need to contact the hospital to call it. Contact PD and wait with the wife (where ever she wants to be). Comfort her as much as possible. If she reaches for a hug then sure.


----------



## NomadicMedic (Feb 12, 2015)

The dead person is not your patient anymore. The wife is. Give her all the emotional support that you can. And in the instance of an obvious death, my partner would usually leave the room to call, while I'd try to comfort the family. You do what you're good at.


----------



## Tigger (Feb 12, 2015)

Here the paramedic still has to call to get a time of death. So we try to allow that to happen while still providing as much support as possible. We also strive not leave until someone arrives to help comfort the family, may it be family, friends, clergy, or the victim's advocate. It isn't fair to the family nor is fair to the single deputy that is often left with the scene.


----------



## Amelia (Feb 12, 2015)

I loce these answers. Here we have to call the MD if the patient has onvious sign of death, then the MD calls time of death. DEMedic, love your comment. It will probably stick with me. I love learning with you guys.


----------



## Ewok Jerky (Feb 13, 2015)

Call MD for time of death, call coroner/PD for body recovery.  At this point there is no patient and we are all just human beings standing around a recently deceased family member.  I consider myself a human being first, EMT second and act accordingly, which includes any level of physical and emotional comfort you are comfortable with. I consider myself a spiritual though not religious person, and in these situations I will follow the family's lead and do what I can do make them at peace including hugs, praying, talking, remembering, calling family or friends whatever.  Its OK to cry with them too.   I would usually go out of service until I can get PD and some emotionally stable family/friend/neighbor on board to take control.


----------



## Ensihoitaja (Feb 13, 2015)

For us, we don't need to call for obvious signs of death. Our medical director's name goes down as the pronouncing doc*. We'd notify police if they're not already assigned and they call the ME. We'd also do anything we could to help family- like *DEmedic* said, that's our patient now.


*As a result, he pronounces more people than any other doctor in the state.


----------



## Amelia (Feb 13, 2015)

Its amazing the different protocols everywhere, eh?


----------



## systemet (Feb 14, 2015)

Amelia said:


> You roll up on a call for a cardiac arrest. Once you get there you see obvious signs of death. Wife in denial or distraught as anyone would be. A) do you leave the area to inform MD of the situation or stay with deceased patient? B) Wife reaches for a comforting hug- youre allowed right? Id want a hug if my husband just died in front of me!
> 
> Thanks!



Usually we just call the cops. We don't have to contact a physician. So, for us, it's a simple as calling on the radio that it's a 9B and we need police.  I don't normally need to leave the immediate area to do this.

The dead body isn't getting any more or less dead if you hug the wife, and care for her first. Your dispatch should have the time you arrived on scene stamped, or tracked on GPS. I don't think it matters if you call for the police / ME now or in five minutes. They're going to estimate the time of death based on the autopsy.


----------



## chaz90 (Feb 14, 2015)

I'd never have everyone leave the distraught family member unless they asked. If I'm alone on the call, calling the doc for a pronouncement on an obvious DOA can wait until someone else arrives to stay with the family. Like DEmedic said, the more common situation is one medic stepping away to call as the other stays with the family. In any case, the call isn't made until all details are gathered and more pressing matters are attended to. 

We wait on scene until LE arrives to be with the family. From the time someone arrives on scene, the family isn't left completely alone until after the decedent is gone as well.


----------



## samiam (Feb 15, 2015)

100% fine to give a hug and maybe steer away from the deceased. Call it in on the radio, depending on protocols pop on the monitor and look for the flat line (I saw a guy do this to someone with his head no longer attached... I was like really? Apparently some places you have to confirm no matter the circumstances). Also dont do this.


----------



## Amelia (Feb 15, 2015)

Samiam- GOD do I love Family Guy!!! Thank you!!!!


----------



## JeffT (May 11, 2015)

in class we were told that the only obvious sign of death that we can actually consider an obvious sign of death in this type of situation is decapitation... of course this is an emr level class, not an emt level class... is that rule of thumb the same for others?


----------



## SeeNoMore (May 11, 2015)

No. Typically rigor mortis and dependent lividity are assessment findings that would indicate attempts at resuscitation are futile.


----------



## chaz90 (May 11, 2015)

JeffT said:


> in class we were told that the only obvious sign of death that we can actually consider an obvious sign of death in this type of situation is decapitation... of course this is an emr level class, not an emt level class... is that rule of thumb the same for others?


That shouldn't even be the case for EMR or layman level. A better list of obvious signs of death includes incineration, skeletalization, decomposition/bloating, rigor mortis, or severe head injury with brain matter showing and vital signs absent.


----------



## joshrunkle35 (May 11, 2015)

A simple rule of thumb is that if they are dead and you don't work them, you should be able to specifically articulate why. You can't just say, "Well, they looked dead to me." You should be able to explain in detail what specific signs you saw that evidenced that they were dead and had 0% chance of survival. If they look dead, but you can't specifically articulate why, then work them until you can transfer them to a higher level of care.

Obviously, follow your protocols. My advice was meant to be a simple suggestion of a good guiding principle, not specific advice for your situation.


----------



## Accelerator (May 13, 2015)

By our protocols it is actually illegal for us to begin resuscitation on a body with obvious signs of death. We could lose our job, etc. Specifically incineration, decapitation, frozen solid, cut in half, rigor, dependent lividity, and traumatic arrest prior to ems arrival.

We generally have to print a tape at least. 

I don't think anyone would fault you for hugging and consoling a new widow. No amount of training can make you less human. Frankly if you wouldn't hug her back I'd have to check your air conditioning vent for blood slides.


----------

