Podcast
Questions and Answers
In the El Paso Fire Department EMS Guidelines for Obvious Death on Scene (DOA), which of the following criteria must be present along with pulselessness and apnea to declare obvious death?
In the El Paso Fire Department EMS Guidelines for Obvious Death on Scene (DOA), which of the following criteria must be present along with pulselessness and apnea to declare obvious death?
- Trauma and submersion in warm water for more than 30 minutes.
- Past medical history of cardiac disease and resuscitation efforts prior to arrival.
- Recent illness and witnessed event by EMS personnel.
- Dependent lividity, injuries incompatible with life, or rigor mortis. (correct)
According to the El Paso Fire Department EMS Obvious Death on Scene guidelines, under what circumstances should EMS providers consider coordinating with law enforcement at a death scene?
According to the El Paso Fire Department EMS Obvious Death on Scene guidelines, under what circumstances should EMS providers consider coordinating with law enforcement at a death scene?
- If resuscitation efforts were performed prior to EMS arrival.
- If the provider recognizes a suspicious or traumatic cause of death. (correct)
- If the patient has a known history of respiratory disease.
- If the death occurs during a diving incident.
According to the El Paso Fire Department EMS Guidelines, what specific finding in a pulseless and apneic patient with a traumatic mechanism would lead an EMS provider to determine there is no respiratory effort and asystole, thus supporting the withholding of resuscitation?
According to the El Paso Fire Department EMS Guidelines, what specific finding in a pulseless and apneic patient with a traumatic mechanism would lead an EMS provider to determine there is no respiratory effort and asystole, thus supporting the withholding of resuscitation?
- Patient has a known DNR/POLST order.
- Patient has been submerged in warm water for >30 minutes or cold water for >90 minutes.
- Patient exhibits no respiratory effort after basic airway maneuvers; and asystole on ECG. (correct)
- Patient is witnessed by EMS personnel.
Consider a scenario where a patient is found pulseless, apneic, and with signs of decomposition. According to the El Paso Fire Department EMS Guidelines, what is the most appropriate initial action?
Consider a scenario where a patient is found pulseless, apneic, and with signs of decomposition. According to the El Paso Fire Department EMS Guidelines, what is the most appropriate initial action?
According to the El Paso Fire Department EMS Guidelines, in which of the following situations would CPR and resuscitation ALWAYS be indicated, irrespective of other factors?
According to the El Paso Fire Department EMS Guidelines, in which of the following situations would CPR and resuscitation ALWAYS be indicated, irrespective of other factors?
According to the 'Pearls' section of the El Paso Fire Department EMS Guidelines, providers encountering which of the following scenarios should request law enforcement to the scene via dispatch?
According to the 'Pearls' section of the El Paso Fire Department EMS Guidelines, providers encountering which of the following scenarios should request law enforcement to the scene via dispatch?
What specific detail regarding fetal gestational age is mentioned in the El Paso Fire Department EMS Guidelines, influencing protocols related to death on the scene?
What specific detail regarding fetal gestational age is mentioned in the El Paso Fire Department EMS Guidelines, influencing protocols related to death on the scene?
Based on the information from the El Paso Fire Department EMS Guidelines for obvious death, which of the following differentials are most likely to be considered by EMS providers?
Based on the information from the El Paso Fire Department EMS Guidelines for obvious death, which of the following differentials are most likely to be considered by EMS providers?
What factors should be present for EMS providers to consider withholding resuscitation based on the El Paso Fire Department EMS guidelines?
What factors should be present for EMS providers to consider withholding resuscitation based on the El Paso Fire Department EMS guidelines?
Following the El Paso Fire Department EMS Guidelines, in a prolonged submersion case, what temperature and time parameters would lead a provider to consider the patient potentially resuscitable?
Following the El Paso Fire Department EMS Guidelines, in a prolonged submersion case, what temperature and time parameters would lead a provider to consider the patient potentially resuscitable?
Flashcards
Criteria for Obvious Death
Criteria for Obvious Death
Pulseless & apneic with one or more of: Dependent lividity, injuries incompatible with life, decapitation, decomposition, incineration, exsanguination, or rigor mortis.
History for Obvious Death
History for Obvious Death
Past medical history, hospice, recent illness, last seen alive, mechanism of injury, trauma/medical, resuscitation efforts prior to arrival, and if the event was witnessed by EMS.
Criteria to withhold resuscitation
Criteria to withhold resuscitation
Unresponsive, apneic, pulseless, unresponsive pupils, and one or more of the following: rigor mortis and/or dependent lividity, decomposition, decapitation, incineration or obvious mortal wounds.
Differential Diagnosis in Cardiac Arrest
Differential Diagnosis in Cardiac Arrest
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Traumatic Arrest Criteria
Traumatic Arrest Criteria
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Prolonged Drowning/Submersion
Prolonged Drowning/Submersion
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DNR/POLST Impact
DNR/POLST Impact
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Fetal Death
Fetal Death
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Study Notes
- El Paso Fire Department EMS Guidelines focus on obvious death on the scene (DOA).
History
- Pertinent historical information includes past medical history, hospice care, recent illness, when the patient was last seen alive, the mechanism of injury or illness, trauma/medical history, any prior resuscitation efforts, and whether the event was witnessed by EMS personnel.
Criteria for Obvious Death
- The criteria include the patient being pulseless and apneic, along with one or more of the following:
- Dependent lividity
- Injuries incompatible with life
- Decapitation
- Decomposition
- Incineration
- Exsanguination
- Rigor mortis
Universal Patient Care Guideline
- Assess if the patient meets the criteria for obvious death or has a Do Not Resuscitate (DNR)/Physician Orders for Life-Sustaining Treatment (POLST) order.
- If yes, discontinue CPR if started.
- If not, proceed with CPR and resuscitation efforts.
- If the provider recognizes a suspicious or traumatic cause, coordination with law enforcement is necessary.
Termination of Resuscitation (TOR)
- Assess if the patient meets the criteria for TOR.
- If yes, discontinue CPR if started.
- If no, follow the appropriate cardiac arrest guideline.
Differential Diagnosis
- Considerations include primary cardiac disease, respiratory disease, homicide/suicide, diving accidents, trauma, asphyxiation, toxic exposure, and overdose (OD).
Pearls
- If a provider feels the need for law enforcement on scene, they should make the request via dispatch.
- Criteria for withholding resuscitation: unresponsive, apneic, pulseless, unresponsive pupils, and one or more of the following present:
- Rigor mortis and/or dependent lividity
- Decomposition, decapitation, incineration
- Obvious mortal wounds (severe trauma with signs of organ destruction)
- Patients with suspected traumatic mechanism found pulseless and apneic by EMS providers with no respiratory effort after basic airway maneuvers and in asystole on ECG (AED with display or ECG monitor).
- Prolonged drowning/submersion: >30 minutes in warm water (>43°F >6°C), >90 minutes in cold water (<43°F <6°C).
- Fetal death with a fetus <20 weeks by best age determination available at the scene requires special consideration.
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