Police Officer Killed in the Line of Duty after giving Mouth-to-mouth

[DoC352]

Deputy Sebastian Diana of the Orange County, Fl. Sheriff's office died in the line of duty after giving a 3 month old infant mouth-to-mouth during a call for an infant in cardiac arrest 5 years ago. The deputy had been out sick from work since 2007, fighting a bacterial infection he contracted when the he came into contact with some of the infant's vomit while attempting resuscitation. Deputy Diana, a father of four, died in his home last weekend.

http://www.firefighterclosecalls.com/news/fullstory/newsid/131851

Firstly and most importantly: my deepest condolences to this man's family.

Now for the meat: Unfortunate freak accident or absolutely preventable line of duty death?

---

Members don't see this ad.

 

[DoC352]

I'll be the first to say it, this LODD was absolutely preventable and should not have happened. This officer should have at a very minimum been equipped with and appropriately trained in the use of an acceptable barrier device to prevent the kind of contact with bodily fluids which occurred during the incident in question.

 

[Hernandez]

what bacterial infection could he have contracted that takes that long to kill that isn't treatable?

 

[SFO-IST]

this thread title is overly dramatic. "Killed" sounds like someone killed him. he allegedly caught a bacterial infection and died from an infection.

 

[DoC352]

this thread title is overly dramatic. "Killed" sounds like someone killed him. he allegedly caught a bacterial infection and died from an infection.

eh perhaps, but I still say that if we are to believe what we are told the events of that day killed him, albeit slowly.

also I can't change it now even if I wanted to.

 

[Dwindlin]

Now for the meat: Unfortunate freak accident or absolutely preventable line of duty death?

If the death is really the result of the mouth to mouth then it was preventable, however I know of no places that require someone to perform mouth to mouth. Most departments discourage it, or out right make a policy against it. Even in a pedi arrest if you don't have airway barriers the recommendation is compressions only. This officer made a conscious decision to put his health at risk in attempt to help another, it is a very sad situation, but ultimately a decision he made.

 

[TerraMedicX]

My guess would be that he contracted bacterial meningitis. It's more common in the pediatric population and colder certainly lead to cardiac arrest and is easily transmissible in body fluids.
Should he have used a barrier device? Absolutely! But I have to say that cops are not as used to the concepts of BSI as FFs and medics are, and many don't carry pocket shields or don't think to dig them out of their trunks! Having run an unfortunate number of pediatric arrests, I have to say that even I would have a hard time not giving rescue breaths to a child in arrest. Statistically, the risk of contracting ANYTHING, little lone anything fatal are very slim, but this is just one of those rare incidents.
My deepest condolences to his family!

Nate.

 

[DoC352]

My guess would be that he contracted bacterial meningitis. It's more common in the pediatric population and colder certainly lead to cardiac arrest and is easily transmissible in body fluids.
Should he have used a barrier device? Absolutely! But I have to say that cops are not as used to the concepts of BSI as FFs and medics are, and many don't carry pocket shields or don't think to dig them out of their trunks! Having run an unfortunate number of pediatric arrests, I have to say that even I would have a hard time not giving rescue breaths to a child in arrest. Statistically, the risk of contracting ANYTHING, little lone anything fatal are very slim, but this is just one of those rare incidents.
My deepest condolences to his family!

Nate.

I agree that the risk of contracting a disease from performing mouth to mouth is slim, but it's like wearing gloves - there is a simple, cheap, and effective protection if people are just trained to use it properly on every call.

I think it's absolutely unacceptable that this officer allegedly died because his department was either unwilling or unable to provide him with the protective equipment he needed to do his job safely, and the training to know how and why to use it.

 

[Dwindlin]

My guess would be that he contracted bacterial meningitis. It's more common in the pediatric population and colder certainly lead to cardiac arrest and is easily transmissible in body fluids.
Should he have used a barrier device? Absolutely! But I have to say that cops are not as used to the concepts of BSI as FFs and medics are, and many don't carry pocket shields or don't think to dig them out of their trunks! Having run an unfortunate number of pediatric arrests, I have to say that even I would have a hard time not giving rescue breaths to a child in arrest. Statistically, the risk of contracting ANYTHING, little lone anything fatal are very slim, but this is just one of those rare incidents.
My deepest condolences to his family!

Nate.

5 years after the call?

 

[Dwindlin]

I think it's absolutely unacceptable that this officer allegedly died because his department was either unwilling or unable to provide him with the protective equipment he needed to do his job safely, and the training to know how and why to use it.

I highly doubt this is the case. If they didn't provide them with barriers then I would bet that they had a policy of no mouth to mouth. And most officers are required to be BLS certified, and again this is a class that harps not to do mouth to mouth.

Edit: After re-reading what I wrote I feel like it sounds as if I am blaming the officer for what happened. That is not my intent. I think by this point it is fairly common knowledge that mouth to mouth can be unsafe (look at the increased bystander CPR rates in places with compression only CPR classes). To suggest that this officer did not know the risk I think is somewhat insulting to him. Instead I think this officer made a conscious choice to put his safety at risk. It is truly unfortunate the price he paid. But he should be respected, and honored for his selfless decision.

 

[DoC352]

I highly doubt this is the case. If they didn't provide them with barriers then I would bet that they had a policy of no mouth to mouth. And most officers are required to be BLS certified, and again this is a class that harps not to do mouth to mouth.

Edit: After re-reading what I wrote I feel like it sounds as if I am blaming the officer for what happened. That is not my intent. I think by this point it is fairly common knowledge that mouth to mouth can be unsafe (look at the increased bystander CPR rates in places with compression only CPR classes). To suggest that this officer did not know the risk I think is somewhat insulting to him. Instead I think this officer made a conscious choice to put his safety at risk. It is truly unfortunate the price he paid. But he should be respected, and honored for his selfless decision.

Whatever the case, the fact that the exposure occurred means that the officer did not use an appropriate protective device. Whether it was because he didn't have one, wasn't trained properly in its use, or he personally didn't think he needed it (due to lack of appropriate training on the risks of mouth-to-mouth), he died a very preventable death.

I don't mean to disrespect this officer, and I clearly feel that he should be honored for his sacrifice. But IMHO it would be utterly disrespectful of this officer's memory not to do everything in our power to prevent something like this from happening again. When the solution to the problem is something as cheap and easy as a pocket mask, even one dead provider is clearly one too many. So all I'm saying is that we, as a whole emergency response community, need to do everything we can to raise awareness of the risks, however small, associated with mouth-to-mouth and the simple methods that can be used to reduce that risk.

 

[deleted6669]

most pocket masks would be too big for a 3 month old.
maybe he contracted HIV infection....or hep c...time course works...( I know it says bacterial but that may be an error on the part of the reporter).
when I was in Haiti one of our em docs gave direct rescue breathing to as newborn covered with meconium in resp. arrest. talk about hard core....baby lived. as far as I know no poor outcome to the doc....old time er doc...one of the first em residency grads..very old school. he used to go home and wash the blood out of his hair after shifts at work.

 

[Dwindlin]

JEMS just did an article about this as well, they said he died of heart failure. Makes me think he either contracted myo or endocarditis.

 

[ILikeSugar]

But according to most good samaratan laws, a CPR provider must assist/serve at the level of their training. We were trained to give 30 compressions/2 breaths. Do you think that we could be sued if we were willing to do compressions but not breaths?

I started looking this stuff up after my mom told me about a doc in our church who didn't come forward when the pastor kept on asking for a doctor to help a lady who lost consciousness.

I mean...that must have been SUPER AWKWARD when everyone knew she was a physician. I think I'd be willing to do chest compressions on anyone. But I would be a little squeamish about mouth-to-mouth if I didn't have a barrier.

 

[Hernandez]

But according to most good samaratan laws, a CPR provider must assist/serve at the level of their training. We were trained to give 30 compressions/2 breaths. Do you think that we could be sued if we were willing to do compressions but not breaths?

I started looking this stuff up after my mom told me about a doc in our church who didn't come forward when the pastor kept on asking for a doctor to help a lady who lost consciousness.

I mean...that must have been SUPER AKWARD when everyone knew she was a physician. I think I'd be willing to do chest compressions on anyone. But I would be a little squeamish about mouth-to-mouth if I didn't have a barrier.

did your ACLS instructors not tell you the AMAs position is compressions even without breaths I preferable to nothing at all? and this route has increased the rate of bystander CPR significantly from what my instructors were saying.

 

[pseudoknot]

But according to most good samaratan laws, a CPR provider must assist/serve at the level of their training. We were trained to give 30 compressions/2 breaths. Do you think that we could be sued if we were willing to do compressions but not breaths?

Good Samaritan laws protect you from liability if you act. They do not require you to do anything. And as noted above, AHA guidelines say that compression only CPR is reasonable if you are a bystander or do not have PPE.

 

[ILikeSugar]

Thanks! Now I can breathe a bit easier the next time I'm on a flight.

 

[leviathan]

AHA guidelines say that compression only CPR is reasonable if you are a bystander or do not have PPE.

As I'm sure you already know, there's at least one good trial that shows better outcomes with compression-only CPR for bystanders. That is usually in your witnessed non-hypoxic arrest patient. If I ever witness a sudden arrest, I think I would only do compressions, even IF I had a barrier/pocket mask. In that initial time window the patient needs good continuous cardiac output and shouldn't have interruptions to that flow, especially if you're going to make it worse by introducing positive pressure.

If it was an unwitnessed arrest, or if it was probably a hypoxic arrest, then I think that changes the story.

 

[pseudoknot]

Agree with leviathan's post, as always.

 

[KD1655]

I recently read about a firefighter "LODD" (as classified by the US Fire Administration) in which the FF died from a confirmed transmission of hepatitis B some 20 years ago while on an EMS job. I consider the above case of the police officer to be just as much of a line of duty death as if he were to be shot. The bottom line is that he died as a result of an on duty incident...PERIOD.

I have had the very unfortunate experience of being on several pediatric codes in the field and I can tell you that in the moment I think I (and probably a good deal of others on here) would have done whatever I could, up to and including mouth to mouth, if it meant resuscitation. I just think that this case is a very hard one to Monday morning quarterback because the adrenaline and chaos factors just aren't there.

 

[AegriSomnia]

I have had the very unfortunate experience of being on several pediatric codes in the field and I can tell you that in the moment I think I (and probably a good deal of others on here) would have done whatever I could, up to and including mouth to mouth, if it meant resuscitation. I just think that this case is a very hard one to Monday morning quarterback because the adrenaline and chaos factors just aren't there.

I've done pediatric codes as well when I worked on the ambulance and there is no reason to expose yourself for any reason. If you feel that you would provide ventilation by mouth without protection you should buy a mouth shield and keep it on your key ring. It is a LODD, but it was most likely preventable. Sad.

 

[Julyjoe88]

most pocket masks would be too big for a 3 month old.
maybe he contracted HIV infection....or hep c...time course works...( I know it says bacterial but that may be an error on the part of the reporter).
when I was in Haiti one of our em docs gave direct rescue breathing to as newborn covered with meconium in resp. arrest. talk about hard core....baby lived. as far as I know no poor outcome to the doc....old time er doc...one of the first em residency grads..very old school. he used to go home and wash the blood out of his hair after shifts at work.

I firstly have to say one thing. there are specially made infant pocket masks now and second back in the 50s is before alot of modern diseases like Aids and HIV were arround and manny others I may add. but in the case of this officer he should have been at least first responder certifyed even though depending on what agency he is from he may not even have much more then basic CPR and first aid certificate fore it is not the responceabliity of Cops in most cases to respond to medical calls. and the reason why i know this is because my father worked for a useless agency (not to be named because i live near there and work for mutual aide and assistance there) but that agency and others arround it did not have a first responder certification and only required there cops to know one thing adult and child basic CPR/lifesaver training which we all know you might as well burn for all the good that card will do ya! but all an all he was out of his element and did the best he could. also to the writer of this forum even though a fireman who is killed because of smoke inhalation 50 yrs later is considered killed in the line of duty by the local press dosent mean he was and in the case of this cop he was killed outside the line of duty due to an infection that could have been caused by almost anything!