I was reading a county medical examiner’s autopsy report, and it said the deceased had two disposable defibrillator pads on the chest, and faint, illegible writing. That’s all it says about that, but it seems like the kind of thing you’d want to elaborate on. So I figure it must be normal, and the examiner thought nothing of it and moved on.
Where would the writing come from? Did the paramedics likely do that? Would someone else in the routine path from death to autopsy have written on the body?
I was taught in my long-ago first aid training that after you apply a tourniquet, you have to write the time and you used it in a visible location on the victim’s body (with a marker if you have one, with the vic’s blood if you don’t). Removing a tourniquet can be dangerous, even lethal, so it’s very important to know how long it was on.
They write on you when you go in for an operation as well. If you’re having a knee operation, they’ll write “yes” or something similar on the knee to be operated on. They do not write “no” or anything on the other knee. Writing can get smudged or possibly rubbed out by pre-op procedures so they a smudged ‘no’ or the absence of any mark to indicate proceeding. If the yes gets rubbed out completely so neither knee has a mark on it, they can then check and confirm
I’ve seen doctors write and draw on patients. It’s done prior to surgery as mentioned above, and occasionally prior to radiology. It’s a good idea, the tourniquet case mentioned above is a good example. A paramedic may note some information but won’t know for sure if that gets passed along to the next person to see the patient so writing critical info on the patient is a good way to make sure that info will be seen.
I read a story years ago where a patient wrote all over her good knee that is was, in fact, her good knee … and would the surgeon please operate on the other knee …
When my doctor sent me in for a thyroid biopsy years ago, he used a paper form that had boxes to check off for whichever body part he wanted examined. He made an X through “Thyroid” that was so large and sloppy that he effectively checked off “Trans-Rectal Prostate” as well. I considered writing “WRONG END” or something like that on my rear, but I thought about it too late, and the cab driver was not willing to help me.
When my daughter had knee surgery two or three weeks ago they wrote “yes” on one knee and “no” on the other.
And a couple people initialed but I don’t remember who did that to confirm the notations were on correct knee.
OK. Well they don’t write “no” at Yale New Haven. My son had knee surgery there last March and was told explicitly why they don’t write “no” as I reported above.
I’ve seen people in surgery pre-op rooms with “yes” and “no” (or “right” and “wrong”) written on their two legs, respectively.
[My experience with having procedures done is that they ask you repeatedly to confirm what you’re in for, first in the pre-op room and then in the OR. But I’ve never been written on.]
I don’t know where the writing came from. No, it is not likely that the paramedics did that. Paramedics do sometimes need to write things down, usually vital signs or times that they administered drugs or defibrillatory shocks. If they are not able to access whatever they are recording on (chart or tablet), they usually write on the disposable gloves they are wearing, or infrequently, on their own arm.
As others have pointed out, patients are written on sometimes. Pre-op locations are common. Pulses such as a dorsalis pedis are marked when they are needed. Skin infections are frequently outlined in order to see if they are improving or getting worse.
I have seen many hundreds of people from the unloading by the paramedics through to the zipping up of the body bag, and I can’t recall a single example where someone wrote on the patients chest. I can see it possibly being done in a mass casualty situation, but the chest is not the best place even then.
I have never seen a first responder even attempt to write something “with the vic’s blood”. Whoever was telling you that was full of it. Blood is easily smeared and removed, making any effort to write something legible, a waste of time.
Writing vitals on the patient is a part of our mass casualty training. When dealing with multiple patients this method makes it easier to see which patients have been evaluated and prevents mixing up of notes between different patients.
When i was having surgery to deal with a bone infection in a finger, the surgeon came out to me in the prep area and asked me which finger it was. I said “the one that’s all red & swollen & infected. Can’t you tell?” He said “yes, but you need to TELL me to make sure”. So I told him, then he said he was going to write on it to mark the correct finger, and he did. Then at least 3 more nurses or doctors asked me the same question before they put me under.
Seems like overkill, but I didn’t object – it was my finger at risk, so better safe than sorry was quite persuasive to me at the time.
It might have been some off duty medico and he wrote on there to ensure the pre-CPR/defrib state was recorded, so that the effect of the illness and medicines on vitals can be assessed.
A paramedic or even ambulance driver or patient transfer driver has forms to record the info,
but someone off duty might be just have wanted to write it down, so that when they handed over to on-duty emergency services in five minutes time , they’d be able to be sure of what the info was.
The on duty medico then works for a half hour or hour , which thoroughly blurrs the writing, and seemingly has to give up on this poor yorrick.
My driver’s ed class in high school there was a first aid section … if we were to apply a tourniquet, then treat for shock by covering the victim with a blanket … also, the tourniquet would be covered so it was important to mark the victim somehow so first responders knew who to respond to first … and if need be use the victim’s blood and put a “T” on their forehead …
This was before AIDS came into the USA … maybe that’s not taught anymore …
Bear in mind that I was taught this stuff in infantry basic training. While the medics carried magic markers, us regular grunts didn’t, and blood is better than nothing.
Back last century, when I worked for the NHS, we had a large disaster exercise which simulated a train wreck with a lot of dead and casualties with a wide range of problems. If a first responder administered morphine, I think they put a large “M” on the patient’s forehead.
Records in this situation would be useless because they would lag too far behind (they were kept obviously, although the FR might not know any details of the patient). Medics further down the line needed to know that an opiate had been administered, partly to avoid an overdose, but also so that they would not underestimate how serious the injuries were (“On a scale of 1 to 10…”) (“I feel great…”).
When I had knee surgery the anesthesiologist came to the waiting room and, without identifying himself, casually sat down beside me and asked me several pointed questions regarding the article I was reading.
Once he was happy with my state of mind (as far as that can go, lol) he pulled out a sharpie and told *me *to mark the knee requiring surgery.