Deceased Subjects

 

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 ?

 

  • No

 

    • Continue with resuscitation per appropriate protocol

 

  • Yes

 

Natural death scene ?

 

 

 

    • Contact primary care physician

 

    • Contact Coroner

 

Patient released by Coroner ?

 

  • No

 

 

  • Yes

 

 

 

 

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.

NRP

National Registry Paramedic

NRP

National Registry Paramedic

NREMT

National Registry Emergency Medical Technician