paramedics and death

[AVPU]

Two questions, mainly for my curiosity:

1. Can paramedics declare someone dead, or does a physician need to do that? If so,

2. Does that physician need to be on-scene? (assuming this is an out-of-hospital scenario)

Thanks!

 

[emtstudent04]

Medics CANNOT declare someone dead a physican has to. The physician does not have to be on scene its over the radio.

Thats what they did when i went on a call for a Pt that had coded we did CPR for a lengthy period of time they finally got on the radio contacted the base hospital and the physician pronounced the Pt.

 

[medic417]

Depends on service, city, state, and country.

Here I stop all efforts or decide not to start efforts. Yet we wait for a judge or doctor to make it official. I have had all efforts stopped for more than 2 hours before judge could be contacted, so patient time of death per that judge was 2 hours after all efforts ceased. Other judges will ask what time it was when we stopped and they list that time. Can be in person or on phone.

 

[akflightmedic]

Medics CANNOT declare someone dead a physican has to. The physician does not have to be on scene its over the radio.

Thats what they did when i went on a call for a Pt that had coded we did CPR for a lengthy period of time they finally got on the radio contacted the base hospital and the physician pronounced the Pt.

I suggest you spend some time in EMS before making such matter of fact statements.

It varies by region as someone already said...state, service, county, medical director. It does not have to be over the radio or phone, it can be done without ever speaking to a doctor.

We can choose to not start resuscitation, we can choose to end resuscitation efforts after we have begun if allowed by whatever authority we happen to be in at that time. It all depends, but the short answer is Yes, paramedics can declare someone dead.

 

[emtstudent04]

Well im sorry i said that im just going from what i was told. I was told you can stop CPR under certain circumstances or withhold CPR under certain circustances regarding local protocols. I was told you can refrain from any resuscitation to obvious signs of death. Never did i hear or read that Medics can declare death in a Pt. unless it's obvious. I was under the impression once resuscitation has been initiated you can stop, but to declare a Pt you must make BH contact for a physician. If im wrong i stand corrected. I know i still have a lot to learn.

 

[clibb]

This is what I've heard.
In Colorado, Paramedics are allowed to declared someone dead if they show Asystole on a 6 second strip.

 

[vienessewaltzer]

I would suggest reading your local protocol to find out what to do in any particular situation. In NY, the medical examiner/investigator gets contacted and dispatched for DOA's. Basically, your state's protocol will provide a much more granular answer.

 

[AtalantaAsh]

I was under the same impression, that only a physician or JP can pronounce a PT. dead, but I agree that it is different from city, service, state, or even country.

 

[Sassafras]

I've only had one call where death was called. Medic pushed drugs, we pumped the chest and did rescue breaths, after a while of trying to get a shockable rythm to no avail the medic contacted medical control who gave permission to stop efforts. They then told me the EMT-B to call it and I said "no thanks" so the medic did it. Not sure the last bit was permissable or not, and I wasn't comfortable with calling it so I shirked responsibility to the medic.

 

[emtstudent04]

Well then i wasnt a 100% wrong. I agree as well that it is different everywhere you go. I was just going off of what i was told and what i somewhat know due to the lack of experiance i have.

 

[medic417]

Well then i wasnt a 100% wrong. I agree as well that it is different everywhere you go. I was just going off of what i was told and what i somewhat know due to the lack of experiance i have.

That's why it is important to explain this is per my local areas policy or this is what my instructor told me. The way stated it was like it was the absolute final answer. We're all guilty of doing that at times so don't sweat it just learn from it so people can understand more fully what you are saying.

 

[emtstudent04]

That's why it is important to explain this is per my local areas policy or this is what my instructor told me. The way stated it was like it was the absolute final answer. We're all guilty of doing that at times so don't sweat it just learn from it so people can understand more fully what you are saying.

That is very true good point and will do.

 

[jjesusfreak01]

I've only had one call where death was called. Medic pushed drugs, we pumped the chest and did rescue breaths, after a while of trying to get a shockable rythm to no avail the medic contacted medical control who gave permission to stop efforts. They then told me the EMT-B to call it and I said "no thanks" so the medic did it. Not sure the last bit was permissable or not, and I wasn't comfortable with calling it so I shirked responsibility to the medic.

Thats interesting. I know it varies by region, but I find it slightly difficult to believe that they would let an EMT-B call it. Maybe they just wanted someone to say it out loud.

 

[Shishkabob]

Medics CANNOT declare someone dead a physican has to. The physician does not have to be on scene its over the radio.

No.



Depending on where you work, Paramedics, and sometimes even EMTs, can cease resuscitation efforts, or even refuse to start, without contacting a higher authority.

 

[emtstudent04]

How can you refuse to start resuscitation on a Pt unless there are obvious signs of death or DNR? Wouldnt that be considered negligence on your part?
I'm aware now that it's different everywhere, but that doesn't make any sense to me??

 

[ExpatMedic0]

How can you refuse to start resuscitation on a Pt unless there are obvious signs of death or DNR? Wouldnt that be considered negligence on your part?
I'm aware now that it's different everywhere, but that doesn't make any sense to me??

death secondary to trauma would be an example

 

[emtstudent04]

death secondary to trauma would be an example

Ok well i can see that. What about if it's a medical pt?

 

[rescue99]

Two questions, mainly for my curiosity:

1. Can paramedics declare someone dead, or does a physician need to do that? If so,

2. Does that physician need to be on-scene? (assuming this is an out-of-hospital scenario)

Thanks!

No and No.

 

[ExpatMedic0]

Ok well i can see that. What about if it's a medical pt?

Local protocols. Last time we had a patient expire the only M.D. we called was the medical examiner. Just waited with the body for almost 2 hours before he showed up.

 

[LondonMedic]

Ok well i can see that. What about if it's a medical pt?

Purple.