The electric shock almost never is used to start a heart that is not beating , TV and movies get that wrong. I guess it makes for a good visual. Shock is used to restore the normal rhythm of the heart. Most of the time they use drugs to try to start the heart back up.
If you are not breathing and have no pulse you are dead. If everything lines up exactly right and the stars are aligned it may be possible to change that. That is what I’ve been taught for 30 years.
That would never happen anywhere I know. Fatal auto accidents are treated as a crime scene. If the person is dead they are pronounced at the scene and not moved until the medical examiner gets there to photograph and document the scene as well as the fatal accident team. The body and the crime scene are disturbed as little as possible. It may later be determined to be an accident with no criminal charges but no way to know that at the time.
In other circumstances I would much rather have them take the body and not leave us to baby sit. I’ve been told very clearly by the paramedics that they would get in a lot of trouble if they bring in someone obviously dead.
The automatic defibrillators will only shock if they detect a rhythm.
Guess we all went to the wrong schools, and you went to the right one. :rolleyes:
This is wrong. Coroners don’t declare death; they pursue an inquiry into cause of death, and many coroners are not physicians.
What you have been taught, while consistent with the medical definition of ‘death’, is wrong. People have been successfully resuscitated after tens of minutes of no respiratory or cardiac function (albeit typically after immersion in freezing water). However, in this particular circumstance, a general order to abandon a patient that does not respond to CPR is an essential triage measure to avoid wasting time that might save a responsive patient.
Stranger
did that not create some type of sense of impending doom in your house? or maybe a distrust of the common man or something? I’d think I’d be always on edge in that environment.
Maybe so, but at the very least in Upstate South Carolina in the 1980s and 1990’s, the local coroner traveled to the scene of fatal accidents before the body could be moved. The police would announce that the coroner had arrived at the scene. I heard it hundreds of times over the years.
No? If anything, being more aware of what was going around you was helpful. There was always a scanner running in the house from when they bought the first one around 1980 or 1981 until my grandmother’s death in 2010. I didn’t feel a need to keep one on myself, but there was nothing nerve-wracking about it, it was just something in the background of life that you could tune out if it didn’t interest you. (The scanner picked up police, fire and rescue. Along with rescues you would hear play-by-plays of hot pursuits.)
I guess in these circumstances, the next call is to the funeral home. Who I would hope do do something about it that’s better than simply leaving a dead person in place.
Still unbelievably horrible, though.
Ah, today’s leading local news story was on how funeral homes are being overwhelmed.
I’m telling you, it’s scary as fuck here. This guys got bodies in his chapel with his air conditioning as the only cooling.
I’m a lapsed EMT but, from memory, those conditions were decapitation, brain separated from the skull, lividity, and obvious signs of decomposition.
One of the reasons the first heart transplant was performed in South Africa is that their laws allowed it. In most places, a person could not be declared dead until their heart stopped for a certain period, long enough to be useless for transplant. But to remove a beating heart was to risk prosecution for murder. After Barnard’s success, many places lobbied for brain death to be an alternative measure so heart transplants could be attempted.
Their are several tests one does to check for brain death, but I won’t describe them here. Suffice to say, thinking you don’t feel a pulse is not death. I’ve even revived people asystolic in three leads, though someone was right defibrillation is not helpful for asystole. Other methods are used for slow bradycardia.
If you continue not to breathe or have a pulse you are dead. But not in the moment, only after a certain amount of time. Physicians talk to the coroner after they think someone dead (if certain criteria mandate this) and often fill out the paperwork. In most cases the coroner waits until morning to review things.
As for training of NY paramedics, couldn’t say. It’s a scary situation there. Other places will be similarly scary in 2 weeks, perhaps, and also will want respirators and medical personnel.
Thanks I’ve performed CPR many many times. I’m well aware of what can and does happen.
I’m sure it depends on the location. Here an official pronouncement can only come from a doctor. It may be done over the phone and using remote telemetry but it’s always a doctor on the other end.
Obvious signs of death means the EMTs don’t have to try lifesaving efforts.
I’m not saying the OP heard wrong but if the protocols have changed in NYC it would have to be in writing and from an official source. You don’t just have EMTs pronouncing death because someone told them verbally.
In the 9+ years I’ve spent as an EMT (I’ve had to retire from active duty due to a back injury that left me with arthritis in my spine and sciatic nerve damage), I’ve transported several dead bodies. Sometimes to the morgue, sometimes to a funeral home. I’ve also been able to pronounce someone dead on two different occasions.
In my area, a basic EMT can pronounce someone dead in the case of an obvious death. Decapitation, for example. Or lividity (when the body’s blood pools at the lowest possible spots because the heart is no longer pumping and gravity kicks in).
As I said, I’ve pronounced two: one was a decapitation in a car accident (Kia t-boned by a garbage truck), and one gentleman who stuck a shotgun under his chin and pulled the trigger.
Leaving a patient to die is unconscionable to me. I can’t even wrap my head around the concept.
I worked a massive freeway pileup (80+ patients) where we had a bunch of catastrophic trauma and burns. Many of those Definitely alive, but few lived long enough to be extricated.
interesting. was your grandmother the one that listened to it most or something?
I understand it in the abstract. Fortunately, I was never in a situation where I had to make those snap triage decisions. All of my mass-patient runs only had, at worst, one to two serious injuries. I worked a wedding celebration balcony collapse once that had upwards of 45 patients, but even most of those were bruises and scrapes.
It’s in the single digits.
CPR works best for young, healthy people who have suffered an arrest due to some sort of trauma. It’s not very effective for the aged, or for those who have suffered an arrest due to serious illness because re-starting a heart in those cases does not solve the underlying problem that lead to the cardiac arrest in the first place.
Right now, medical care is limited. I know that’s hard for a lot of Americans to wrap their heads around, but it’s true. There is not enough to go around the situation is going to get worse before it gets better.
Also, if you bring someone to a hospital right now in NYC if they don’t already have covid there’s a significant chance they’ll pick it up there.