EMS questions

pesamystik

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Hey, i'm writing a short story about a paramedic so excuse me if these questions seem a bit odd.

I was curious as to whether or not a corpse is dropped off directly at the morgue? I don't mean an aged body, but maybe someone who died in transit to the hospital?

Is it possible to stop the heart with lidocaine and jump start it with EPI in a matter of a few seconds?

I don't know if those are the proper drugs to illicit those reactions though.

Anyway, sorry for the strange questions. Any replies would be appreciated.
 

SafetyPro2

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Not being a Paramedic myself, I can't answer the drug question, but in regards to the first one about transport of a body, it varies greatly from state to state. In California, for example, we don't transport "dead" bodies. If we arrive on-scene and determine that the patient is truly dead (we have specific criteria for what are called "obvious signs of death"), then we document such and call the police and they wait with the body until the Medical Examiner or Coroner arrives, and they transport the body to the morgue. Occasionally, if the deceased was under a doctor's care for a terminal condition, the body can be released directly to a mortuary (and they'll handle the transport).

Now, if we arrive and the patient is clinically dead (no pulse, no breathing) but still in a possibly treatable condition (i.e. they went into arrest and someone immediately called 911), we'll start working on them and continue to do so while we transport them to the hospital. In that case, even if we can't resuscitate them, they're not technically considered dead until a doctor "calls them", or pronounces death, in the ER. Same goes if the patient goes into arrest during transport.

Its different in other states, however. EMS units in some states do transport dead bodies from the scene either to a hospital or a morgue, while others are like us.
 

croaker260

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I was curious as to whether or not a corpse is dropped off directly at the morgue? I don't mean an aged body, but maybe someone who died in transit to the hospital?

No typically, you tranpsport to the ER, where there the MD makes his official "Yep, they're dead" Observation, and from their to the morge. This is assuming its dead as dead can be (wich makes you wonder why they would be transported by an ambulance to begin with..but that does vary local to local), if there are still rescucitative efforts ongoing, then those will continue, likely ending with a very sage proclomation..."yep, they're dead".


Is it possible to stop the heart with lidocaine and jump start it with EPI in a matter of a few seconds?
No. The drug actions are listed below. Secondly, since both drugs are given (usually) IV, then when the heart stops beating, the blood stops moving and the drug stops circulating. Unless your doing CPR, which is AT BEST 30 % of normal blood flow, usualy more like 15%.

Lidocaine is to suppress potentialy lethal dysrythmias, it does not stop the heart per se. I dont know how to explain it to the lay public except to say it keeps the irregular nasty undesirable electrical activity suppressed or muffled, while allowing (hopefully) more normal electrical activity to surface and control the heart. THIS IS A GRAND OVER SIMPLIFICATION.

Epi's action is multifacited in arrest situations. First it is a "Vasopressor" , it makes all the blood vessels cinch up, puching blood to the vital organs (like the heart and the blood vessels around the lungs) Second, It also changes the hearts receptiveness to electical impulses..both good and bad, and both internal and external. Hopefully the heart will respond to intrinsic internal "good" impulses, or at least to external ones (pacing or defibrillation).

I hope this helps.
 
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pesamystik

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Thanks for your replies, the reason I ask about whether EMS transports bodies to a morgue because within my story our Paramedic develops a love interest for one of the women who works in the morgue.

What about this situation? The doctor pronounces the body is dead within the hospital. Would it seem out of the ordinary if the paramedic brought the body to the basement?

I suppose if all else fails I can always just fictionalize things a little bit, but I like to be somewhat authentic.

Thanks for the replies again.
 

ffemt8978

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Where I came from in South Dakota, the local ambulance services transported ALL deceased bodies to the morgue, unless they were taken directly to the funeral home.

I worked as a security officer in the hospital that had the regional morgue. Security was the only department that had access to the morgue after hours and we maintained the only official records of the bodies to pass through there, so we were constantly having to deal with the incoming and outgoing bodies.

The way it worked was after EMS arrived on scene, they would contact the coroner who would come out and officially pronounce the body and determine if an autopsy was going to be performed. Then they would contact the on-call pathologist, who would authorize us to receive the body into the morgue (usually about 5 minutes after they arrived :blink: ), and we would take custody of the body until the autopsy was performed.
 

SafetyPro2

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Originally posted by pesamystik@Jul 31 2004, 08:18 PM
What about this situation? The doctor pronounces the body is dead within the hospital. Would it seem out of the ordinary if the paramedic brought the body to the basement?
Again, around here, it wouldn't happen that way, but could in other areas. Once we hand off the patient to the ER staff, we have nothing further to do with them. If the patient is called in the ER, the hospital's Transport staff would handle moving the body to the hospital's morgue area (where it would be held until released to the ME or a funeral home).
 

croaker260

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Is it possible? Sure. Depends on the area. Medics taking bodies to the morge are more likely in smaller locals, so it depends what setting your writing in. Could be your female love interest comes to the scene to pick up the body and do the initial coroners investigation..mainly a formality to get "the facts straight", as the deputy coroners do here. We interact with those guys and gals every day.
 

ffemt8978

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Originally posted by pesamystik@Jul 30 2004, 07:38 PM
Hey, i'm writing a short story about a paramedic so excuse me if these questions seem a bit odd.
I don't suppose you'd consider posting your story, or more likely a link to it, here so that we can all read it when you're done, would you?

I'm curious as to the plot line, and would be interested to see how you pull this off.
 

rescuecpt

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Or it could be one of those freaky busy days and the ER (ED) staff could ask the medics to wheel the body down to the morgue as a favor to them.
 

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