# Medic pronounces still-breathing woman dead



## TheLocalMedic (Apr 24, 2014)

So this happened:  

http://www.ems1.com/fatal-incidents/articles/1890660-Medic-pronounces-still-breathing-woman-dead/

Kinda makes you want to facepalm, doesn't it?  I'm curious if anyone else has heard of similar incidents.


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## MSDeltaFlt (Apr 24, 2014)

Yes, i have.  And a lot closer to my home than I dare mention.


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## mycrofft (Apr 24, 2014)

Nothing like quoting the grieving layperson husband as your primary (if not exclusive) source.


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## DrParasite (Apr 25, 2014)

how do you get a pronouncement without being asystole on the monitor in at least 3 leads?


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## Anjel (Apr 25, 2014)

If we have an "obvious death" we do not have to run a strip. 

But obvious is... Missing 3 or not limbs, decapitation, full body 3rd degree burns, lividity, rigor, etc.  

But I highly doubt she had any of those if she was still breathing.


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## medicdan (Apr 25, 2014)

DrParasite said:


> how do you get a pronouncement without being asystole on the monitor in at least 3 leads?



We actually don't run strips on many pronouncements here. The way we see it... we do not resuscitate based on physiological criteria (Decapitation, Trunk resection, incineration, purification, destruction of brain or heart, etc.). Asystole is a treatable rhythm, and none of the physiological criteria require cardiac monitoring to determine. 
We can cease resuscitation after ACLS measures have been attempted and are not successful, but that's a different story.


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## lightsandsirens5 (Apr 25, 2014)

That article is extremely poor, as far as reporting quality goes. I am absolutely certain there is more to the story.

And the whole


> Her husband questioned the medic's judgment, who made news last September when he called a medical helicopter for two children who had no major injuries — just cuts and bruises — after being hit by a heavy shelf.



Is really a nice touch...how on earth does that relate?


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## OnceAnEMT (Apr 25, 2014)

lightsandsirens5 said:


> That article is extremely poor, as far as reporting quality goes. I am absolutely certain there is more to the story.
> 
> And the whole
> 
> Is really a nice touch...how on earth does that relate?



Odd to see a story on an EMS-specific website that seems to have a bias against EMTs/medics. 

Husband seemed pretty cool about it. No crazy verbage, no fun adjectives.


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## Handsome Robb (Apr 25, 2014)

lightsandsirens5 said:


> That article is extremely poor, as far as reporting quality goes. I am absolutely certain there is more to the story.
> 
> And the whole
> 
> Is really a nice touch...how on earth does that relate?



I think it was meant to show how big of an idiot this guy really is. Did you ever read the story associated with that event? He basically forced HEMS transport on these kids completely against the mother's will because of the MOI if I remember correctly. 

I don't have to run a strip if I'm pronouncing someone on an obvious sign of death. Supposedly that's changed since I got hurt but reading our protocols it says an ECG should be attained unless doing so would disrupt a crime scene...well guess I still won't be doing ECGs on obviously dead people since they're part of a crime scene...and obviously dead.


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## wanderingmedic (Apr 25, 2014)

Ugh. It's people like this that make me cringe. Don't mean to start this thread down a bunny trail, but people like that "medic" are reasons for higher educational and licensure standards that emphasize critical thinking.

flying a ped with a bump on her head to at trauma center + calling a DOA on a pt who was still alive = major questions about this guy's judgement and critical thinking ability.


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## mycrofft (Apr 25, 2014)

I don't know if the EMT was as totally negligent as it was made to sound, but a simple stethoscope would reveal if any resp or organized cardiac activity was going on...while you or your partner applied the ekg electrodes or AED.

Reminds me of the comment a few days ago in which someone said you could guess a serum glucose level by clinical signs.:unsure:


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## DrParasite (Apr 25, 2014)

mycrofft said:


> Reminds me of the comment a few days ago in which someone said you could guess a serum glucose level by clinical signs.:unsure:


assuming you mean a blood glucose level, we do this all the time... usually on an apparently hypoglycemic patient, each medic and/or BLS provider will guess a number, and the person who is closest is treated to lunch or breakfast by the person who was further away.

not sure what you mean by this comment.....


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## mycrofft (Apr 25, 2014)

The commenter implied a recordable glucose level number was deducible from clinical signs alone, not just HI or LO.
Or so I inferred.


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## WolfmanHarris (Apr 25, 2014)

If this medic did a poor, extremely brief physical assessment I can see trismus being confused with rigor mortis. If the Pt. died of a closed head injury it is certainly a possibility. Doesn't excuse it, but does help lead to a root cause identification for how this critical error was made.


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## Drax (May 22, 2014)

There was an mnemonic device for obvious signs of death that I can't for the life me remember from like the second day of EMT class.

It was 8 signs, I think 5 of them were:
Decomposition, Decapitation, Incineration, Lividity, Rigidity

Can't recall the rest...Basically anything looking dead a while, burnt to a crisp, or without a head isn't going to be able to be brought back to life.

Different EMS systems have different stances on when to call it in the end though.


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## UnkiEMT (May 22, 2014)

My absolute favorite phrase in EMS was given to me in my basic class as one of the reasons not to initiate CPR: "Injuries incompatible with life."

Off topic: a medic I used to work with was diabetic, and could keep operating way below a BGL I'd be happy to see, I once saw him do a test and come back with a 46, he was just a little extra *****y at the time.


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