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Question about cardiac arrest


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Emt in medic school and just wondering about calling an unattended death. is lividity without rigor in a warm unwitnessed cardiac arrest enough in your opinion to not start Cpr? Classmate brought up the discussion and it's been debated amongst us students. Local protocol states lividity and/or rigor and obviously apeniec and pulseless. Am I wrong to consider it situational such as someone in bed or climate controlled areas? 

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Not entirely sure what you're asking.  Are you wondering if you should work a person who died in bed, is still warm because the blankets were pulled up to the chin, is pulseless and apneic, has asystole confirmed in three leads and has noticeable lividity just because they're still warm?

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I would not work this person.  To do so would only offer false hope to the family.  The person fits the criteria for death.  I would show the family the asystole on the EKG and explain that it  means there is no heartbeat thus no circulation.  I would explain the purpose and necessity for circulation and  I would show the lividity on the person's body and explain that it is the result of no circulation.  Then finally I would explain that after 5 minutes of no circulation the brain  along with all of the other organs of the body has begun to die.

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Teaching point

What is lividity?

Answer that question and you I think answer your question to this group.

But no I would not have worked this patient either.  Lividity to me, equals death.  Lividity added to unwitnessed no estimated down time definately equals death.

the dead person is no longer your patient.  The family is.  Walk them through what is going to go on from here on out.  Prep them for when the coroner gets there and their loved one is prepped to be removed from the home.  Ask if you can help them make phone calls if they need someone to be called like a family member or their pastor or Imam or whoever they want you to call for them. 

If the police are there, you more than likely can clear the scene and leave.  there is no sense for you to remain on scene if you do not have to.  

go with the flow on what feels comfortable and right.  there ARE NO right or wrong answers here after the family member has been called.  Ped's opens a whole new dynamic and that dynamic sucks big donkey balls simply because it's a pediatric patient.  Your emotion and the emotional quotient ramps up a thousand fold especially if you have a kid about the same age as the one who passed.  


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