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Tones go off we get a call for a cardiac arrest, arrived on scene to be greeted by a person saying his uncle passed away, he drank himself to death. As we are pulling out the gurney He said we won't be needing that, but we grabbed it anyway. We walked inside to find our pt, supine and pale. I assessed for a pulse no pulse, no breathing. 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. His brother insists that we don't do cpr and we are not to take him. We made contact with a MD just to confirm what we are doing and get in on record. I really can't think of anything else we could of done. Would you guys work him or do the same thing

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Orange County, CA protocols clearly states that EMS personnel are to honor requests from immediate family members to "withhold or withdrawal resuscitation." The patient's relative in your story has essentially given the patient a "do not resuscitate" order in the system I used to work in. Unfortunately where I work now doesn't have quite so liberal DNR protocols. Regardless, dependent morbidity makes the patient a DOA.

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Lividity, even a small amount is a sign of death. No need to start regardless of family wishes.

I cannot comment on "Family Wishes", but that, as quoted, is one of the signs of "obvious death", accompanied by breathless and pulseless, per NYS DoH and FDNY rules regs and protocols. No CPR indicated, notify for PD, leave the deceased in Police presence.

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One of the last calls we ran before I went on med leave was for an "unconscious/fainting". When we got to the scene the pt looked sound asleep. The inside conditions were quite warm so the body was still at room temp. No idea how long it had been there for BUT once the arm was lifted off blankets for a pulse check which is when obvious lividity was found. A couple mins on the monitor to finish off my job and it was left at that. ALS who had been called a while back arrived on scene-had them check as well and the RCMP was called. They finished things off-I went back to bed.

I think in a sense it's what sucks the most about what we do. The bodies don't so much bother me, it's life but its some of the grievers that bug me.

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Orange County, CA protocols clearly states that EMS personnel are to honor requests from immediate family members to "withhold or withdrawal resuscitation." The patient's relative in your story has essentially given the patient a "do not resuscitate" order in the system I used to work in. Unfortunately where I work now doesn't have quite so liberal DNR protocols.

Really? Regardless of pt age, history, current medical condition?

Not sniping, I'm just curious. So given the pt above, minus dependent lividity, you would choose not to work him based soley on the relatives say so?

Dwayne

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