Resuscitate of SIDS

[jmac]

So you run a strip on a decomposing body...fantastic policy. You should really speak to your doctor about that, because it might be one of the stupidest things I have heard of in EMS.

I do not make policy, and as for a decomposing body, unless it is us that are the first response, no we do not run a strip, we do have some leaway, that is a police matter for investigation.

but we do run a strip on all deceased for hard copy to go along with our report form and if it is the stupidest thing you have ever heard....there is a lot out there that would really amaze you,

keep safe.

[Ridryder 911]

If one can not determine a dead, pulseless, body with conclusive signs of death, (or know what that means) then one does not need to be in this business. Period. Better go back to school, clinical etc..

Because you do not know how to perform your job accurately, is non-excusable. If you cannot detect a dead person, how in the hell, am I supposed to trust you with a live one? Guess what I wouldn't. Like I said, I would have the physician talk to your director or even the state boards. One that cannot determine a cold, levity, with rigor mortis does not need a certification or license. We are not talking about rocket science...

If you have to err on the side of "oh, what my happen?", then you need to check in another profession. Resuscitate or attempt those that meet the criteria that have a chance, not to those that are OBVIOUSLY DEAD. So, do we now attempt resuscitate most traumatic arrest as well?

This scenario was simple enough for even non-medical trained persons.. refer to basic CPR training.

R/R 911

[hfdff422]

I am not sure why cost is considered (I would not), but time spent on a dead body is counterproductive when it could be spent counseling the grieving parents.

[Eric]

yes i would work it all i can i have lost my son to sids on 12-26-01 so i have been the dad you see not knowing whats going on only wanting you to do all you can and what the hell it cant hurt to try and save the baby

[bandaidpatrol]

:? Work a decomposing body?

I suppose if you dumped type specific blood, NS, LR, EPI, Atropine, bicarb and lidocaine into the embalming machine and just kept pumping it around you could put them on a respirator and leave them that way for about a hundred years. May want to flash out the internal organs though, or that may bring up a problem. But you wouldn't want to use a trocar because that would seriously screw up your chances of getting the blood to the lower extremities. As for the darkening flesh, maybe add some tissue preservative, less the formaldehyde, as then you wouldn't have a snow balls chance in hell of getting them back when it's possible two hundred years from now. May as well just save the CNS in a cryogenic freezer somewhere.

Gives me an idea to blog.

[jmac]

wow, really deep bandaid 8) 8)

[TechMedic05]

"but we do run a strip on all deceased for hard copy to go along with our report form and if it is the stupidest thing you have ever heard....there is a lot out there that would really amaze you, "

Well, kind of a side note...A state in my area advises against performing any ECG on a patient you will not be working. Most likely for the traumatic patients, it's a 'Don't go looking for something you do not want to find."

[Ridryder 911]

"but we do run a strip on all deceased for hard copy to go along with our report form and if it is the stupidest thing you have ever heard....there is a lot out there that would really amaze you, "

Well, kind of a side note...A state in my area advises against performing any ECG on a patient you will not be working. Most likely for the traumatic patients, it's a 'Don't go looking for something you do not want to find."

Our medical director has the same opinion.. like the old saying "don't take the temp, you won't find the fever".. LOL

Now, seriously we are not talking about questionable or maybe situations... we are talking about, conclusive. One that are either have post mortem hemostasis, rigor, etc.. I was discussing this situation with an old Paramedic professor now attorney, he was described doubtful, but litigation could be held against EMT's for not following the standard of care .. even on the deceased. Especially if the autopsy or ER physician agrees it was too late for resuscitation measures to be started. Again, we are talking about obviously dead... if you flag an adult not an infant you are performing age discrimination.... there is no difference in criteria. etc..again, doing what is taught. Not knowing is why the thread was brought up....

R/r 911

[jmac]

just on the strips, we do not have the litigation issues you have there, as i said this is done as hard copy for proof that we were there and the PT was declared by an MD or that there were signs incompatible or after ALS has failed...nothing strange...not that we do not know that the PT is deceased but as hard copy for data recovery to go with the arrest proforma and memory card,

keep safe.

[vs-eh?]

yes i would work it all i can i have lost my son to sids on 12-26-01 so i have been the dad you see not knowing whats going on only wanting you to do all you can and what the hell it cant hurt to try and save the baby

Eric,

While your loss was unfortunate, that does not excuse you to initiate resuscitative measures on an obviously dead patient (no matter what age). In reality all you are doing is desecrating a body, plain and simple folks. If anything it gives you a real understanding of what the parents are going though and you can aid them in their initial phase of mourning.

So you decide to initiate resus and transport (this is for all levels)...

- Jaw is rigored so you can't do laryngealscopy, no tube, so you bag...

- No IV is possible, no drugs down the tube (cause you can't get one), so IO it is (if you are able to do it)...

- Kid is asystole so you are running the arrest like that, do your first round of epi 0.01mg/kg 1:10,000 and start to roll...

- You are obviously going lights and sirens because this is a kid...

- The parents don't go in the ambulance, and drive their own car, you tell them not to follow you, but they ignore you and are on your tail all the way because "there baby has a chance"...

- You are increasing your risk of being in/causing an accident by a very significant amount, as are the parents who are following you...

- You get to the ER, with the parents 1 min behind you...

- ER Doc says "Ok, page for an RT, lets get the...Wait a sec this baby is cold...I can't move the jaw...(flips baby over)....there is dependent homeostasis...what was the downtime time again....WTF ARE YOU GUYS DOING!!!!"

- Doc, nurses, etc.... are looking at you like an idiot, parents are wondering what is going on....

- And in the US they get a fair sized bill for your "life saving" efforts, that would have always been futile...

Moral = Do not start resuscitative efforts on any patient of any age that have signs of obvious death.

This also falls back on education and length of precepting. Talking to your patients on routine calls, and especially family in times of their tragedy is not something that is "learned" in 150 hours of class room time and 48 hours of preceptorship. It takes time to develop your "style" and earn a patients and grieving loved one's trust in times of tragedy. Giving false hope does NOT make you a better professional.