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What would u do??


crazyemt5150

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I would have worked it, you have no legal standing not too. For all you know, brother has been pumping him full of antifreeze for the past several days.

You did not mention the patient's age ????

The pts age is irrelevant in this case. Lividity is pretty much a universally accepted sign of the game being over. Why would you desecrate the body in a completely futile attempt? Maybe the brothers were poisoning him, so what. You are not an ME/CSI, your job is done. There is nothing further that can be done for this guy by EMS or the ER. I agree, it does seem a little suspicious so I would make sure to notify the ME (or PD depending on local customs) and let them know of your concern.

Lividity+asystole=DRT

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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.

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Seems pretty clear that he fits a good definition for "really quite sincerely dead"

Sounds like you did everything right on this one.

Now if we remove lividity from the equation, the problem of the family's wishes becomes a bit more interesting. Sounds like there's some real variance among systems. Another Ontario provider can correct me if I'm wrong, but if there's not a valid DNR or they're obviously dead, then I have to run the arrest. Dealing with this person's next of kin could be difficult.

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read again:

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.

I think we all read it properly. No one was talking about rigor. Lividity starts between 30 minutes-4 hours after death. This guy died at least 30 minutes ago. There is no reason to attempt a resuscitation. I would agree with DocHarris, if you take the lividity out of the equation you are in a quagmire. In that case I would attempt to explain to the brothers that legally they have no say in what is done (in a more gentle and kinder way) and that you have to run the code. Get PD involved if need be.

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Definitely a DNR. The lividity, asystole, down time, mottling, etc. All are a dead giveaway to not resuscitating. (pardon the pun). ME has to be contacted anyway. If there was something suspicious about the death and the family, then it's the Coroner's Office and the DA's gig.

Usually with long hx. of ETOH, age can be deceiving. Just this past July a childhood friend of mine passed away basically from dinking herself to death. She was only 42. I hadn't seen her in about 11 yrs. but they said she looked 62.

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read again:

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.

Patient is legally dead. Crotch failed at his own reading exam.

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you dont know that it was lividity, it might have been a bruise. pt still warm, down time unknown.

Whatever. Have you never heard that all patients that are dead are warm and dead. If cold then other criteria comes in.

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