History:
- Person encountered by EMS who meets criteria for obvious death
- Patient with a valid DNR who is pulseless and apneic
- Patient with other approved advanced directive requiring no CPR be administered who is pulseless and apneic
- Patient for whom resuscitative efforts are ceased on scene
- Name of primary care physician
- Known medical conditions
- Last time known to be alive
- Fetal death
Definitions:
Natural death scenes:
- scenes where there is reasonable evidence that the person died of natural causes (i.e., illness, old age, etc.)
Unnatural or questionable death scenes:
- scenes outside the definition of a natural death (i.e., violence, trauma, drugs or drug paraphernalia, hemorrhage, fetal death and/or products of conception, pediatrics, questionable or insufficient information to identify cause of death, patients <60 years old without an extensive medical history, etc.)
High morbidity cases:
- cases in which EMS personnel believe that patient death may be imminent as a result of unnatural causes (i.e., fetal death, pediatric cardiac arrests, trauma with RTS <6, priority one trauma, high percentage burn, high voltage electrocution, drowning, etc.)
Patient meets criteria for discontinuation or has injuries incompatible with life ?
-
- Continue with resuscitation per appropriate protocol
Natural death scene ?
-
- Contact primary care physician
- Contact Coroner
Patient released by Coroner ?
Unnatural, questionable or traumatic death scene ?
- Contact Coroner and Law Enforcement
- Leave the immediate area without disturbing the scene
- Do not move or reposition the body after the initial assessment
- Secure the scene as much as practical
- Complete Death Scene Report
PEARLS:
- If at any time there is a question as to the death scene being a questionable scene, stop inspection and secure the scene immediately and notify the Coroner's office.
- For all high morbidity cases contact the Coroner.
- Contact the patient's primary care physician to certify death and sign the death certificate.
- Greenville County Paramedics may declare a person dead on the scene or during EMS transport. Paramedics are expected to use reasonable judgment, coupled with compassion, when declaring death and/or interacting with the public and other agencies.
- Fetal death includes abortion, stillbirth, miscarriage, and products of conception, etc.
- In the case of natural death, contact the patient's primary care physician to certify death and sign the death certificate. It is acceptable to transfer information through a nurse or other licensed personnel at the physician's office if the physician is unable to come to the phone to certify the death.
- If a physician cannot be contacted or is unwilling to sign the death certificate, notify the Coroner.
- Do not re-enter the scene or immediate area of the scene during the investigation unless requested to do so by the Coroner on-scene.
- Leave in place any and all disposable medical equipment used to assess and/or treat the patient (i.e. monitor pads, inserted airways and IV setups, etc.) until the patient is released by the Coroner.
- When determining death, use caution and move the patient and/or articles (i.e., furniture, etc.) as little as necessary to accomplish the task at hand.
- Patients can be covered if the scene is in view of the public.