This is bothering me

Linuss said:
With a medic partner who doesn't want to touch dead people?
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Are you referring to me? Do you think that's the issue? I've worked in nursing homes and hospitals over the years and I have touched plenty of dead people. This has nothing to do with whether I want to, but whether I should.
 
Chelle said:
Are you referring to me? Do you think that's the issue? I've worked in nursing homes and hospitals over the years and I have touched plenty of dead people. This has nothing to do with whether I want to, but whether I should.
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I was making a facetious joke not aimed at you.


And I also said medic, which you are not.




Sorry for the confusion.
 
I;m really not targetting this at you, but I have a genuine interest i whether your AED actually prints strips. It will of course record them (for later QA/QI purposes, in addition to audio...), but consider whether you really want to be putting two honkin AED pads on this body just to confirm death, when three little ECG stickers will do, from the ALS unit. It should be ALS providers calling Medical Control for the pronouncement anyway... your job as a BLS provider on scene is to decide only whether you are going to start a resuc or not...
 
emt.dan said:
I;m really not targetting this at you, but I have a genuine interest i whether your AED actually prints strips. It will of course record them (for later QA/QI purposes, in addition to audio...), but consider whether you really want to be putting two honkin AED pads on this body just to confirm death, when three little ECG stickers will do, from the ALS unit. It should be ALS providers calling Medical Control for the pronouncement anyway... your job as a BLS provider on scene is to decide only whether you are going to start a resuc or not...
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We have a 3 lead heart monitor that we have been trained to use and run a strip from. All of our B's use it. Does this mean we aren't supposed to be? I'm new enough that I've only used it once, and that's the machine I should have said instead of the AED.
 
Linuss said:
I was making a facetious joke not aimed at you.

And I also said medic, which you are not.

Sorry for the confusion.
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Please forgive my defensiveness. I'm a volunteer who is doing the best I can to eventually become a kick-*** EMT. In the meantime I mostly feel like a dumbass EMT, albeit a well-meaning dumbass. I'm working hard to learn everything I can and combine it with all the training I've gotten over the years. I'm even willing to get my chops busted here, if necessary, to learn and be the best I can be.
 
My service if we start a resuscitation and do a field term. we have to print a strip. If it's a traumatic arrest we don't have to but on an unkown or medical cause if we don't start a resuscitation we have to print a strip. If they have a DNR we don't print one since they can have electrical activity without a pulse it gets awkward there.
 
Not required to run a strip here. We are required to write a chart, and contact the medical examiner.
 
VentMedic beat me to it... but if you keep current on the EMS news headlines... its pretty scary how many times you read that EMS providers (most often Paramedics!) pronounce someone only to find out later onscene or at the morgue that the pt. is still alive. This isn't like one or two instances in 5 years... more like five or so instances in a year.

So its not necessarily a bad idea for protocols to require a strip to confirm. Im not sure I agree with using an AED for this reason though. If its obvious death ie. rigor, lividity, no pulses (carotid/apical)... we always called it as we saw it... never ran strips.

But I dont see anything out of line for running a strip if its in your protocols to do so.
 
Chelle said:
I don't know. How many?

That's why I'm asking.
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Here are a couple of examples:


Lessons learned after baby mistakenly declared dead in wreck
http://www.keyetv.com/news/local/st...stakenly-declared/N5UftPnJjEa-bW_mh0pkeQ.cspx

Woman pronounced dead -- dies next day
http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2004/07/10/PREDEAD.TMP&type=printable


Detroit Man Wakes After EMS Declares Him Dead
http://cms.firehouse.com/content/article/article.jsp?sectionId=17&id=45311

Incident of man still alive pronounced dead prompts new procedures

http://www.wowt.com/home/headlines/9908516.html

Baby born, pronounced dead, then found alive

http://lodinews.com/articles/2007/10/05/news/2_baby_071005.txt

Former medic denies declaring live patient dead

http://www.texasemt.com/web/mobile/w2g_modules.php?name=News&sid=157

Woman Mistakenly Declared Dead by San Antonio EMS
http://emsresponder.com/article/article.jsp?siteSection=1&id=6722





Omaha Fire Department Alters Death Protocol


Man Declared Dead Turns Out to Be Alive
http://abcnews.go.com/Health/Story?id=444211​

[FONT=arial, helv]County sacks EMTs for bagging man alive[/FONT]

 
I was just rereading some of the above links and found a few comments to be, for lack of a better word which is allowed by the moderators, SAD.

http://www.firefightingnews.com/article.cfm?articleID=38265
"Since then, we have re-evaluated our protocols," Battalion Chief Joe Mancuso said. "No patient can be declared dead without a complete hands-on physical evaluation. We feel that's going to address the problem that the guys ran into."
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"No disciplinary action whatsoever,” says Omaha Assistant Fire Chief Mark Rohlfing. “We don't feel that's warranted. They didn't do anything wrong, they just made a misdiagnosis."
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"The investigation showed they followed the protocols," York said. "The problem was in the protocols, not their actions."
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Follow the recipe to the letter.


http://www.texasemt.com/web/mobile/w2g_modules.php?name=News&sid=157
He declined to say how he evaluated the patient.
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Documentation?

The report says Kearney made his determination of death without thoroughly assessing the patient. Kilmer made his determination of death by taking the word of Kearney, who was off-duty at the time, the report said. Neither paramedic used equipment available to check for signs of life before determining Green was dead.
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[FONT=arial, helv]County sacks EMTs for bagging man alive

Catchy little title. ​








[/FONT]
 
Holy crap. I'll never look at the "obvious" dead in the same way again. I really appreciate all of the links, thoughts and information. Thank you.
 
i believe its merely to just state the obvious. kinda the mentality... guilty untill found otherwise....undead untill proven dead
 
In New Zealand, we have the protocol to run a strip from our Lifepak12.
Which, depending on skill level and ambulance, can be a 3,4 or 12 lead.
This goes for all patients that die, including worked codes, not just DOA's.
Which can be done by all skill levels, doesn't have to be a EMT-P, which happens quite a bit in rural area's, because they are not always available.

I've only heard of one case in this area, of a patient that was found to be still breathing when at the morgue...and I do not know if that person had a strip run or not.
(Also not 100% sure if the patient was a hospital patient or had come via ambulance). Did cause a major public uproar, at the time it happened though!

So I guess that it is also a good idea we have to run strips, if nothing else, just to cover the EMS personal.

Cheers Enjoynz
 
We can call an 11-44, but in our area the coroner give the final call on the 11-44. We will do CPR up to 15min, before the coroner shows up. If it is obvious, we just call. Why use the tools on someone that is dead,dead. I rather call the SO Coroner, and let the family grieve without me having to act and make it a little harder on the family. I dont thats what we do. Death is a touchy topic when it comes to people,cultures,religion (I know this is the post, just saying why we call). Just depends on area.
 
VFFforpeople said:
Why use the tools on someone that is dead,dead.
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Refer back to Vent's post.

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?
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And then a little later she provides lots of links.

I've seen someone call contractures rigor. In the area I did rides in, dead isn't dead til you've run a strip of asystole, and confirmed in two leads that it is in fact asystole, not a fine v-fib.

In cases of obvious death, you aren't violating the patient or disfiguring them, you're just putting four (or even three) little stickies on, running a strip, taking the stickies off. It's not like you're show coding, taking an obviously dead person and performing CPR, cannulation, intubation, and giving the family a false hope that they are in fact alive.
 
Kaisu said:
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...
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LOL. Would work except date/time stamp.:P
 
medic417 said:
LOL. Would work except date/time stamp.:P
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Oh I could totally see the QA on that. "So.. you were dispatched out at 2pm... How is this patient's asystole strip from 8am???"
 
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