crotchitymedic1986 Posted December 30, 2008 Share Posted December 30, 2008 Yes, i am familiar with warm and dead, which is usually due the patient being covered up. But can you answer this batman: If the patient has been dead long enough for the blood to pool in the patient's back, why did all the blood decide to pool in one small spot between the shoulder blades ? Link to comment Share on other sites More sharing options...
reaper Posted December 30, 2008 Share Posted December 30, 2008 Because the pt knew you would think it was a bruise and try to resurrect him? Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted December 30, 2008 Share Posted December 30, 2008 OK, answer this then: Why isnt there any lividity in the leg/foot that is hanging off the bed ? If blood has started pooling in one spot in the patient's back, why isnt it pooling in the lowest hanging part of the body as well ---- Oh i know, right after he arrested, all the blood in that leg rushed to that one spot in the back. DDDDUUUUUUUUUUUUUUUUHHHHHHHHHHHHHHH !!!!!!!!!!!! Link to comment Share on other sites More sharing options...
reaper Posted December 30, 2008 Share Posted December 30, 2008 OK, answer this then: Why isnt there any lividity in the leg/foot that is hanging off the bed ? If blood has started pooling in one spot in the patient's back, why isnt it pooling in the lowest hanging part of the body as well ---- Oh i know, right after he arrested, all the blood in that leg rushed to that one spot in the back. DDDDUUUUUUUUUUUUUUUUHHHHHHHHHHHHHHH !!!!!!!!!!!! I checked for rigor, there is no rigor. The pt brother arrives on scene and says I don't want anything done for him, Your not going to take him and do cpr. So My partner talks to him. The pt has no dnr and the brother doesn't have power of attorney. I put the monitor on and its asystole in all three leads. The pt is warm to the touch. My partner and I roll the pt to check for lividity, there is a tiny tiny amount starting between his shoulder blades, and some minor mottleing, on his leg that was hanging off his bed. Are you reading any of these posts? :shock: Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted December 30, 2008 Share Posted December 30, 2008 yes, do you understand the difference between moteling and lividity ? Apparantly the poster did. Link to comment Share on other sites More sharing options...
reaper Posted December 30, 2008 Share Posted December 30, 2008 Yes, I do. Lividity was just starting to set in. If you want to work it, go ahead. While your at it, can you try and bring my grandma back, she has only been down for a few months? :wink: Link to comment Share on other sites More sharing options...
crazyemt5150 Posted December 31, 2008 Author Share Posted December 31, 2008 yes, do you understand the difference between moteling and lividity ? Apparantly the poster did. Yeah the mottleing in the leg was the starting of lividity, or the correct term Livor mortis or postmortem lividity or hypostasis (Latin: livor—bluish color, mortis—of death), one of the signs of death, is a settling of the blood in the lower (dependent) portion of the body, causing a purplish red discoloration of the skin: which looked more like mottleing to me crotchity, I forgot to tell you guys that the pt was last scene at 0430 and was 64yrs old when the heart is no longer agitating the blood, heavy red blood cells sink through the serum by action of gravity. Link to comment Share on other sites More sharing options...
iMac Posted January 23, 2009 Share Posted January 23, 2009 You honor family wishes? dude I hope you and your family get along well. Here unless you wave a DNR at me, I am by law, obligated to work this code. Anyone else has this "honor" option? I have never heard of that. Link to comment Share on other sites More sharing options...
AnthonyM83 Posted January 24, 2009 Share Posted January 24, 2009 Whatever. Have you never heard that all patients that are dead are warm and dead. If cold then other criteria comes in. I have heard that, but it usually refers to unusually cold or where there is reason to suspect an environmental emergency. As soon as the body stops producing heat, its temperature starts falling to equilibration with that of the room. So, you're going to have a lot of cold bodies. You don't warm each one of them up before determining them dead. I would leave up whether or not the spot was lividity for sure to the original poster, though he must be sure he knows about other skin and tissue conditions and be sure it was lividity (or not be sure, valid reason for posting scenario). BTW, LA County will also allow immediate family to refuse resuscitation if all are in agreement (and patient is over 16, I believe). If there was not lividity, I would go with my gut on whether family was acting shady or not. Link to comment Share on other sites More sharing options...
sladey67 Posted January 26, 2009 Share Posted January 26, 2009 The dude is dead. I'm in the business of resucitation not resurection. DOA as far as I'm concerned. 8) Link to comment Share on other sites More sharing options...
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