This is bothering me

Chelle

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At our last mtg we talked about protocols for when we arrive and a person is deceased. We are supposed to run a strip. I can't seem to get over that. I think life and death are both sacred and can't fathom hooking up a dead person to a heart machine so we can have a little strip of paper to prove that the heart is not beating, all while their relatives weep. What?

What are your protocols on this? I'm open to any information that will help me think differently about this. Or not. ^_^
 
Just to be clear, I'm talking about a patient who has obvious signs of death. A patient who we will not treat in any way.
 
When you check out your rig in the morning, run off a few strips of asystole.... then just throw one down when you need it...
 
The protocols for the stations I rode with during medic rides was to confirm asystole in two leads in all "on scene death" included obvious death like rigor and lividity save for the person torn in two or something.

You hook up a monitor, get your strip, and unhook the monitor. You aren't desecrating their body, you're not harming them in any way. What's the problem?
 
When you check out your rig in the morning, run off a few strips of asystole.... then just throw one down when you need it...

Surely you're not suggesting she falsify a rhythm strip on a DOA!?
 
At our last mtg we talked about protocols for when we arrive and a person is deceased. We are supposed to run a strip. I can't seem to get over that. I think life and death are both sacred and can't fathom hooking up a dead person to a heart machine so we can have a little strip of paper to prove that the heart is not beating, all while their relatives weep. What?

What are your protocols on this? I'm open to any information that will help me think differently about this. Or not. ^_^

It is your job, so do what your supposed to, or find a new one.
 
Its the only quantifiable evidence you can attach to your chart to explain the death. Would you feel better getting a BGL?

On your chart, you should indicate the reason your did not start a code (DNR, decapitation, trunk resection, rigor mortis, dependent lividity, decomposition), looking, listening and feeling for breath for 30-60 sec, palpating looking for a carotid for 30-60 sec, pupils (fixed and dialiated), LS (absent), temperature of the body, and a strip indicating the heart is asystolic in 3 leads.
Dont forget who you found the body in the care of, who you released it to (including badge numbers and names of any PD), what you touched, etc.
 
you're not harming them in any way. What's the problem?

I'm thinking out loud here and already questioning the wisdom in that move. lol!

What I'm thinking is that obvious is obvious. Why isn't it enough to document rigidity, etc?
 
Just to be clear, I'm talking about a patient who has obvious signs of death. A patient who we will not treat in any way.

How many headlines have we had this year where the providers said the same thing only to have their patient be found alive by a wrecker driver or ME?
 
I'm thinking out loud here and already questioning the wisdom in that move. lol!

What I'm thinking is that obvious is obvious. Why isn't it enough to document rigidity, etc?

Your state or Medical Director should have a policy about DOAs, especially if you are an ALS-level service. I know MA statewide treatment protocols authorize EMT-Bs not to initiate a code when one of the following conditions are met:
1) Valid DNR
2) Trunk Resection/Decapitation
3) Decomposition
4) Dependent Lividity/Rigor Mortis

I know there are criteria for ALS that include a measurement of temperature, a strip of asystole of a certain length, and a clause that allows them to stop a resuc after a certain amount of time of asystole. Always call medical control in these cases-- as an MD needs to sign the deceleration of death. As well, consult your medical director for details about local protocols.
 
There can be blood pooling, decomposition, and dismemberment of every body part except for the head and the person can still be alive.
 
There can be blood pooling, decomposition, and dismemberment of every body part except for the head and the person can still be alive.

This is something I have never considered and didn't know was possible.
 
Thank you, Dan. I'm going to look into this more tomorrow.
Correct me if I am wrong, but you are an EMT-B. Unless your service has over-equipped you with an LP12 instead of an AED, how would you be running a strip to confirm asystole...?
 
Correct me if I am wrong, but you are an EMT-B. Unless your service has over-equipped you with an LP12 instead of an AED, how would you be running a strip to confirm asystole...?

With a medic partner who doesn't want to touch dead people?
 
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