I am watching The West Wing on DVD. A Secret Service agent was killed in a store robbery and we see the head of the presidential detail kneeling over his body.
How dead do you have to be that the EMTs and all that not to have moved the body? We all know “the body is the most important evidence,” but who decides on the scene that someone is dead enough to be left at the crime scene?
I’m pretty sure that the EMT’s have no authority to declare some one dead(unless it’s obvious like a decapitation or totally crushed head). A gunshot victim would be worked on until transport.
Smart ass answer:Mostly.
I think this has changed in some jurisdictions.
Very good scene, btw. One of the great ones in a series full of great scenes.
I disagree. It was obvious from the moment I realized it was a robbery. (I was expecting the second shooter to from behind however.)
As far as the Air Force is concerned (and probably all DoD come to think of it), any competent medical authority can declare someone deceased. At least according to a mortuary course I took.
I am not familiar with this TV program.
In general a newly-dead victim from trauma or unexplained death will not be pronounced dead at the scene by first-responders unless there are really obvious signs such as part of the head blown off or a vital organ exposed and destroyed. For things like unexplained sudden death or gunshot wounds, even an asystolic non-breathing victim will have resuscitation measures maintained until arrival at the first-responders’ hospital.
If there is evidence the body has been dead awhile, that may change resuscitative attempts, but on average once they are begun they are not discontinued until a physician in an ED evaluates the situation.
This varies a lot by local practices and the comfort level of the first responders. I suppose it may also be influenced by local legal codes, presumed and actual.
In general, few will argue with a first responder’s efforts to save a life. (I have seen endotracheal tubes inserted into bodies with clear signs of decomposition.) Likewise, at least by my experience, trained first resonders are generally trusted to be competent to determine when someone is dead.
There are people up and walking around with clear signs of decomposition: Uncontrolled diabetics, victims of severe frostbite, and the ever-popular gas gangrene, toast of the trenches.
Thank you all.
EMTs in my area have specific protocols for declaring death in the field. Sometimes they will radio in a request to terminate CPR initiated by the fire dept or bystanders.
I’ve heard cops refer to medics as Evidence Mangling Technitions, although there are ways to reduce the impact, absolute crime scene intergrety and finding out who’s only mostly dead, are at cross purposes.
Back when I was a certified EMT in Massachusetts, there were only a few criteria for “obviously dead”:
[ul][li]Rigor Mortis[]Postmortem Lividity(a/k/a Livor mortis, the settling of red blood cells to the lowest parts of the body indicating heart function has long since ceased)[]Decomposition (of the body in general, not things like gangrene or necrotizing fasciitis)Injury Incompatible with Life (e.g., decapitation or transverse bisection, not mere wounds, no matter how horrible)[/ul][/li]
That may have changed since then, and differ between MA and DC, but those were the standards and I believe they’re fairly common. We weren’t allowed to declare some-one to be dead, just assess that CPR and ALS measures were wasted. I think some jurisdictions allow some first responders to actually declare death, but don’t quote me on that.
So, if The West Wing had been Beacon Hill instead, the scene would have been wrong.
If anybody cares enough, I could dig out the specific protocol for San Luis Obispo county.
I wouldn’t mind reading it, if it’s not too much trouble.
This doesn’t jive with what I’ve seen on the first 48*. Often freshly killed victims will be at the crime scene when the police arrive. Unfortunately I can’t give a specific example because I haven’t seen the show in a while, but I definitely remember times where a teenager was shot, a crowd around the scene, and the body still there.
*A TV show that follows real homicide detectives as they try to solve murders
Heh, I WISH our paramedics were allowed to stop CPR once they’ve started it without a doctor directly being present.
One of my colleagues ended up in a house where someone had obviously been dead for several hours, and the family had called the priest and the funeral directors at approximately the same time as the ambulance. The paramedics had, rather enthusiastically, decided to start CPR on a body with signs of rigour.
My colleagues arrived in a house where the wake was in pretty much full swing in the front room, and the paramedics were still in the bedroom doing chest compressions. because they couldn’t stop until authorised by a Dr to do so.
Another of my colleagues had a patient brought in- the victim of an enthusiastic suicide by throat-cutting- where the paramedics were continuing CPR despite the fact that the guy’s trachea, carotids and jugulars had been completely severed at least half an hour before their arrival. Life was most definitely extinct.
Here ya go, I cut and pasted some highlights
and the whole policy is availeable here
http://www.sloemsa.org/policy/pdf/116.pdf
Wait, I don’t get it – why would anybody start CPR at all in a case where any blood they managed to get circulating would just leak out the carotids?
Exactly- but I guess they thought they should try (I’m guessing there were family/friends at the scene), and once they start they can’t stop until told to by a Dr, which my friend did as soon as he laid eyes on the guy.
Stupid rules, we need a nice protocol like the one outlierrn has.
It’s part of the reasons one of my former bosses referred to our cardiac ambulance (which has a doctor in it) as the “mobile death certification unit”. The idea of the ambulance was so that heart attacks could be lysed in their homes, but 9 times out of 10 by the time you got there CPR was in progress and you were being called to say it could stop.
My main problem with the scene is the fact that the dead guy in question - a Secret Service agent who had just gone off duty, and who was still wearing his tux from a presidential event - wasn’t wearing a vest.