Can an EMT pronounce you "legally dead?"

[hermit]

So I'm watching the news tonight and there's a segment on a guy who claims to have had a near death experience. His name is Don Piper (he wrote a book about it called 90 Minutes in Heaven if you're interested) and he was in a "fatal" car accident in 1989.

According to Don, four ambulances arrived and each team of EMTs pronounced him dead and proceeded to cover his body. 90 minutes later and after seeing the afterlife, he miraculously comes back.

Here's my problem: Isn't someone higher up the food chain required to pronounce you dead?

I've read several articles about how "near death" and "out of body" experiences are completely reproducible in the lab. It's no shock to me that when a pastor has the same chemicals floating around his brain he swears he's seen heaven. What I'm having a problem with is the notion of his brain going without oxygen for 1.5 hours. I can't help but draw the conclusion that he wasn't really "dead."

Thoughts?

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[armybound]

There are certain times when we can refuse to treat because we determine them to be dead.. those cases are decapitation and the presence of dependent lividity. I'm not exactly sure if that means we pronounce them dead or if we just know we don't have to do anything.

But aside from those 2 cases, no. We have no authority to pronounce anyone dead. It has to come from someone higher up.

 

[xrevision]

There are certain times when we can refuse to treat because we determine them to be dead.. those cases are decapitation and the presence of dependent lividity. I'm not exactly sure if that means we pronounce them dead or if we just know we don't have to do anything.

But aside from those 2 cases, no. We have no authority to pronounce anyone dead. It has to come from someone higher up.

Right only in cases of decapitation and things like rigor mortis are we allowed to say that they are dead.

 

[GoldShadow]

So what you're saying is, I should not be pronouncing patients with shortness of breath... dead?

 

[leviathan]

We're not the ones signing their death certificates. We can simply refuse to treat, or cease resuscitation in the case of a prolonged arrest without return of spontaneous circulation.

 

[Farmer Jane]

As a nurse, when I find someone dead my note has to look like this: Patient found not breathing, no audible heart beat, no detectible blood pressure. MD notified.

Doesn't matter that said patient was in hospice for pancreatic cancer with mets to the liver, nosireebob, I can't say the patient is dead, can only describe my assessment. The physician, on the other hand, can pronounce death over the phone.

 

[leviathan]

As a nurse, when I find someone dead my note has to look like this: Patient found not breathing, no audible heart beat, no detectible blood pressure. MD notified.

Doesn't matter that said patient was in hospice for pancreatic cancer with mets to the liver, nosireebob, I can't say the patient is dead, can only describe my assessment. The physician, on the other hand, can pronounce death over the phone.

 

[AggieSean]

As a nurse, when I find someone dead my note has to look like this: Patient found not breathing, no audible heart beat, no detectible blood pressure. MD notified.

Doesn't matter that said patient was in hospice for pancreatic cancer with mets to the liver, nosireebob, I can't say the patient is dead, can only describe my assessment. The physician, on the other hand, can pronounce death over the phone.

Often times, EMS will call in over the radio, describe a situation (like an asystolic arrest > 30 minutes) and will ask if a doc will pronounce them dead over the radio.

 

[FutureDoc4]

As previously stated EMT-Basics cannot pronounce anyone dead but should not be initiating CPR/Defib with rigidity or "conditions not incompatible with life" These usually include decapitations and things of that nature. However, even in those cases we cannot declare someone "DOA." Yet, in general, our ability to "determine" when death has occurred is pretty limited. Even paramedics from what I understand, can still not "declare" people DOA but are able to call med control for more complicated causes to stop resuscitation efforts in the field or ask permission not to initiate them (But this usually requires some more vigorous initial assessments which includes hooking up the patient to the EKG and checking for asystole and some other procedures)

 

[bluemonkey]

EMT's cannot pronounce someone dead. They can opt not to treat someone if certain conditions are met: lividity, rigor mortis, decapitation, decomp, etc. A physician must make the actual declaration of death. Pronouncement of death is actually a bit different, involving notification...

 

[armybound]

As a nurse, when I find someone dead my note has to look like this: Patient found not breathing, no audible heart beat, no detectible blood pressure. MD notified.

Doesn't matter that said patient was in hospice for pancreatic cancer with mets to the liver, nosireebob, I can't say the patient is dead, can only describe my assessment. The physician, on the other hand, can pronounce death over the phone.

I don't really understand this.. unless they have a DNR, wouldn't the next logical step be "started CPR/called a code"? I don't get how you can withhold treatment for something like that.

 

[LikeClockWork]

The physician, on the other hand, can pronounce death over the phone.

Oh man, I am SO going to try this with telemarketers when I get my MD. 👍

 

[Farmer Jane]

I don't really understand this.. unless they have a DNR, wouldn't the next logical step be "started CPR/called a code"? I don't get how you can withhold treatment for something like that.

My apologies, I thought that was obvious. Of course, if someone is a full code you code them. When someone is a DNR (which was the case the vast majority of the time for me, as I worked on an oncology floor and later in a unit that took care of hospice patients) I examine them, confirm for the family that the patient is gone, call the doc, etc.