why give false hope

[Flightorbust]

Ok so Ill warn you now this is a bit of a vent thread. But last time I did a clinical in the ER we have an ambulance come in. The medic came rolling in with a 6 month old baby. The first thing I thought while taking over compressions is this kids dead. I saw what looked like dependent lividity. I then heard some one mention rigor. The whole time were working this kid the mom is in the doorway hoping that we can do something. You could see the hope on her face. While doing compressions I wasnt putting out a femoral pulse so someone took over. I didnt find a femoral pulse on the child when eather when he was doing the compressions. But why pull a :censored::censored::censored::censored::censored: move like that. Why give false hope? Your looking at 2 signs of obviouse death (Rigor and the lividity) and you still run it. GROW SOME BALLS, and tell the parents instead of making it worsw on them.

 

[Sasha]

Because the medics are too cowardly to say "I'm sorry, there's nothing we can do."

 

[abckidsmom]

I taught PALS this weekend to some providers who were on their upteenth recert. To shake it up a little, we included telling the aprents the baby died in the scenario. We included calling resources for the parents, and dealing with the repercussions of good and bad word choice.

It was one of the coolest exercises I've ever done in a merit badge class. There was actual learning, and pushing outside of the comfort zone for people who did not want to be there at all initially. Very rewarding.

Me personally, one of the things I like to do the most is tell people that their loved one has died. Not because I like that they died, but because I like being as gentle yet honest as possible with bad news. It is satisfying to know that even in a completely sucktastic situation, somebody was totally on the team of the family, and was taking good care of them.

 

[JPINFV]

Because the medics are too cowardly to say "I'm sorry, there's nothing we can do."

How much training, education, and experience does the average medic have with death notifications?

 

[abckidsmom]

How much training, education, and experience does the average medic have with death notifications?

In my experience, none. Everything I know about the subject I learned in nursing school or working alongside my mom when I was growing up. She likes to help people in our community (small town friends) when the time comes that they need hospice. I have been around dying people intermittently all my life.

 

[Flightorbust]

So am I wrong for being pissed that this was even ran? I mean its bad enough that the police have to come and question the parents and do an autopsy since the death was unattended. But then making the parents watch there child poked with needle's, intubated and CPR done. I will say this was my first death. That doesnt bother me. I can deal with that just fine. Or am I getting mad as my way of compensating.

 

[abckidsmom]

So am I wrong for being pissed that this was even ran? I mean its bad enough that the police have to come and question the parents and do an autopsy since the death was unattended. But then making the parents watch there child poked with needle's, intubated and CPR done. I will say this was my first death. That doesnt bother me. I can deal with that just fine. Or am I getting mad as my way of compensating.

Maybe a little.

If they weren't comfortable telling the mom, and dealing with whatever she asked or said, then they might have said a million hurtful things that would have stuck with that woman forever. Whenever she thought about her baby, she might hear the struggling medic say, "There's a purpose in this, you can always have another baby" or some other BS that could uproot her whole greiving process.

Is there real harm knowing that people who wanted to help, tried to help, did their best, and failed to resuscitate the baby? Not really. It just delays the inevitable notification, and puts the mom in a place where there are chaplains and pediatricians and plenty of staff to help her when she gets the news.

But yeah, I get pissed in the face of ignorance too. It's tough to see something done the total opposite of the way you would have done it, and see pain added to the situation as a result.

 

[NomadicMedic]

I think, in your heart of hearts, you know it was wrong. If the child had dependent lividity and rigor then the medics never should've ran that code. Instead, they should have been compassionate caregivers to the family. As some of the other posters have mentioned, a lot of medics have a very difficult time in saying the words "your loved one has died".

 

[Flightorbust]

Is there real harm knowing that people who wanted to help, tried to help, did their best, and failed to resuscitate the baby? Not really. It just delays the inevitable notification, and puts the mom in a place where there are chaplains and pediatricians and plenty of staff to help her when she gets the news.
.

Yes I feel there is. How much damage was done with false hope. You take some one who is already low, Bring them up only to drop them even lower. Then add the medical bills that the family will incur in this economy

 

[Fish]

Ok so Ill warn you now this is a bit of a vent thread. But last time I did a clinical in the ER we have an ambulance come in. The medic came rolling in with a 6 month old baby. The first thing I thought while taking over compressions is this kids dead. I saw what looked like dependent lividity. I then heard some one mention rigor. The whole time were working this kid the mom is in the doorway hoping that we can do something. You could see the hope on her face. While doing compressions I wasnt putting out a femoral pulse so someone took over. I didnt find a femoral pulse on the child when eather when he was doing the compressions. But why pull a :censored::censored::censored::censored::censored: move like that. Why give false hope? Your looking at 2 signs of obviouse death (Rigor and the lividity) and you still run it. GROW SOME BALLS, and tell the parents instead of making it worsw on them.

You don't transport dead people, no matter the age. You inform the family on scene that their loved one has died, and once you have expressed your empathy and done all you can for them(which is limited since EMS is not in the business of grief counceling) you hand it over to the appropriate resources on scene. PD has a mobel Mental health/Grief Counceling team.

 

[Flightorbust]

I just want to thank you guys. If nothing else youve validated my feelings of being pissed and thats helped.

 

[SSwain]

As a current EMT-B student, and a father of two kids....what would be the best way to tell the parents their baby has died?
I want to know from both sides of this issue...how do you say it? and how will it be heard?

 

[NomadicMedic]

You can't cover it up with any euphemisms. You can't say things like "passed" or "no longer here". You have to be straightforward. I'll look them in the eyes, hold their hand, and tell them that their child has died. I'm a father too, and I can imagine the incredible pain and anguish that they feel. However, you need to make sure that they hear you and that they know that it's final, and that there was nothing anyone could do. And then, I'll sit with them, cry with them, whatever ... The way that each individual medic deals with this is different, but you need to do what works for you.

 

[systemet]

I would try not to be too harsh on that crew. These calls are very stressful, and sometimes people take the easy way out and run to the hospital. I'm not saying that this is right. In fact, I'll emphatically state that it's the wrong decision, and when it's done with the intent of avoiding giving a death notification, outright cowardly. But these are never easy situations.

In some situations the crew is confronted with a volatile scene, without adequate law enforcement resources, and simply has to deal with what they given. This also becomes very complicated when one of the parents has murdered the child.

I would make sure that you're angry because you perceive that the crew didn't act in the best interests of the mother, not simply because you wouldn't have had to deal with the situation if they had called it on scene. They're not responsible for the kid being dead.

I was always taught to be as professional as possible, try and get everyone in one place, work out who the parent(s) are, be gentle with the news but use the word "dead", and be prepared for reactions ranging from nothing to anger directed at me. I was also told, you can't make the situation better, only worse. So try not to make it too much worse. Don't take any negative reactions from the family personally. It's the worst day of their lives.

The best you're going to accomplish here is leaving the impression that you were professional, thorough, polite and demonstrated some empathy. The parents are probably still going to hate you for the rest of their lives, just because you were there when their kid died. That's ok, just don't give them any more reasons.

 

[ah2388]

Since I started in EMS a year and a half ago, I have always said to myself, that I hope I have the strength to perform the actions you've advocated for.

It's definitely the right thing.

 

[BigBad]

Have some heart

Yes Obvious signs of death. But 6 months old, new mother? Sometimes it's more for the mother than anything else to let her see the process that even the ER could do nothing. Has no regard to "grow some balls"

Where I work we are never dinged for transporting a dead kid. Our medical directors and doctors all "get it"

 

[lawndartcatcher]

This is why:

http://www.boston.com/news/local/breaking_news/2009/06/two_new_bedford_1.html

Providers (ALS and BLS) are taught that you work the hopeless pediatric code for the parents. Take a moment to think for a second: You're a parent, and your entire world has just come crashing to a screeching halt when you find your child lifeless. You call 911 because, like it or not, we're the people that are supposed to know what to do. How would you feel if a couple of paramedics walked in, looked down at your (dead) child, and said "Sorry, there's nothing we can do. By the way, get ready for a whole bunch of police and the medical examiner to come in to your house, ask you to re-hash the most terrible event that will ever happen to you again and again, and not even leave you with one physical location that feels safe (since that's going to be where their "baby died")."

If you say "sorry, he's dead" that's it. They didn't get to say goodbye, the room where their child lived is (probably) also the room where their child died, and nothing is ever going to expunge their guilt and anger. Worse, you (and our entire profession) may become the target of all of that anger - "Why didn't you help our baby? Why did you let him die?". Regardless of the fact that the child was dead before you got there you're going to be looked at as the monster who "wouldn't save our baby". (Not "couldn't"; "wouldn't").

No parent wants to see their child stuffed full with tubes and wired like a Christmas tree, but no parent wants to see their child sick or dead, either. If you work the child it a) gets the child out of the house ("The child later died at Rampart General hospital..."), b) it looks like you tried everything you could, and c) it gets the parents into a physical location (the hospital) that's got the kind of support help they'll need. It won't help every parent but it's a start.

 

[Sasha]

Or, you could allow them to spend a few quiet moments with the child, saying their goodbyes, instead of ripping their child from them in a fruitless attempt to revive them and stuffing them full of tubes and wires and playing with the mother's emotions by giving her a sense of hope and sticking them with a ridiculous bill.

 

[abckidsmom]

This is why:

http://www.boston.com/news/local/breaking_news/2009/06/two_new_bedford_1.html

Providers (ALS and BLS) are taught that you work the hopeless pediatric code for the parents. Take a moment to think for a second: You're a parent, and your entire world has just come crashing to a screeching halt when you find your child lifeless. You call 911 because, like it or not, we're the people that are supposed to know what to do. How would you feel if a couple of paramedics walked in, looked down at your (dead) child, and said "Sorry, there's nothing we can do. By the way, get ready for a whole bunch of police and the medical examiner to come in to your house, ask you to re-hash the most terrible event that will ever happen to you again and again, and not even leave you with one physical location that feels safe (since that's going to be where their "baby died")."

If you say "sorry, he's dead" that's it. They didn't get to say goodbye, the room where their child lived is (probably) also the room where their child died, and nothing is ever going to expunge their guilt and anger. Worse, you (and our entire profession) may become the target of all of that anger - "Why didn't you help our baby? Why did you let him die?". Regardless of the fact that the child was dead before you got there you're going to be looked at as the monster who "wouldn't save our baby". (Not "couldn't"; "wouldn't").

No parent wants to see their child stuffed full with tubes and wired like a Christmas tree, but no parent wants to see their child sick or dead, either. If you work the child it a) gets the child out of the house ("The child later died at Rampart General hospital..."), b) it looks like you tried everything you could, and c) it gets the parents into a physical location (the hospital) that's got the kind of support help they'll need. It won't help every parent but it's a start.

You said this so well.

Working the arrest "for the parents" is not always the right thing to do, but I just do not believe that the majority of medics or crews out there have the skills necessary to get the parents through this event without saying something exceptionally hurtful and stupid.

Speaking now as a parent who has experienced loss, I will say that the insensitive thing you say in this situation is magnified and NEVER FORGOTTEN. I am a forgiving person, and I try to forget, but it just doesn't go away. When I think of that time, I remember what that doctor said.

I think that this knowlede should lead you into being cautious, but still comforting. Do not EVER think that you can fix it, or make it better for the parents by what you say. In the heat of the moment, anything other than appropriate sympathy and practical help is running the risk of trying to "fix it" with words.

In my experience, guys especially are oblivious to this "fixing" that happens. It's really important that you (general you) think these things through beforehand to know what not to say to the family.

 

[abckidsmom]

Or, you could allow them to spend a few quiet moments with the child, saying their goodbyes, instead of ripping their child from them in a fruitless attempt to revive them and stuffing them full of tubes and wires and playing with the mother's emotions by giving her a sense of hope and sticking them with a ridiculous bill.

Sasha, I agree with you on this, but I really believe that the majority of people in this field do not have the skills needed to let this happen in the peaceful way you describe. It is not something that is taught, and does not come naturally to everyone.