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29 March 2009

Ob Noo! I'b cork a coold!

And thank modern medicine for the drugs to treat the symptoms.

Occupational hazard to catch a cold every now and then. I take supplements to help prevent such, but with our high level of exposure and seemingly most of our patients don't know that their hand can be placed over their mouth when they cough!!!!!!

You have to cop one.

Well the next shifts really didn't get that much better. Surprisingly my current Padawan who really is going back to school in five weeks or so did have her first Deceased Patient while she was treating.

Initially called to a palliative patient in a supportive role.
On arrival we found ourselves present at the exact time of death.
While death is all part of our job, we seldom arrive at the exact moment.

It's about 8:00am, on a beautiful sunny day.
We are in the bedroom with all the blinds open, a Panoramic view of Sydney Harbour behind us.
Not only are we welcomed by the carer as the Ambos but we are a crew who has been here recently and are recognised giving us that much more of a connection with the patient.

As we are already prepared for the patients condition we calmly check for signs of life and I confirm the findings before acknowledging to the carer what I believe she already knew.

I do what I have to do, advise Comms that the patient is now deceased and request Police to attend as it is an out of hospital death. I then try to contact the patients own Doctor who if able will come to the scene and sign a death certificate that will speed and simplify the next steps.

He is able (saves on a trip to the public mortuary and possible autopsy). But can you answer me this and I think Dragonfly will but then she is a Doctor.

Why can't I complete some form of Death Certification?
I am able to recognise the absence of Respiration, Circulation, Fixed and Dilated Pupils, Cold Waxen pallor, Rigor Mortis, Dependent Lividity, I have a monitor to show the absence of cardiac electrical activity?

Even if it was only for experienced Paramedics.
I've completed my Probation,
I've completed the rest of the training and gained qualification.
I've completed a period as a qualified officer.
I've completed a re qualification course with peers and superior officers and educators.

I believe that I could with precision identify deceased persons in circumstances such as this?

So why does it require a 'Doctor' to come and look, listen and feel to determine that their dead?
They don't even do an ECG!

I wonder how much response I get from this question?

Be careful out there and I'll see you at the Big One.

Taz

1 comment:

Tazambo said...

Yea, you should be able to.

In Tasmania, we (qualified paramedics) have been able to (for about 3 years), complete a "Certificate of Life Extinct".

This is only after the patients doctor has been contacted and is prepared to issue a "Death Certificate" (this includes a cause of death). Doctor does not have to visit the scene.

If the doctor says yes he will issue a Death Certificate, the body can be collected from the scene by the families choice of Funeral Home. The police do not get called.

If the doctor can't be contacted, or isn't prepared to issue a Death Certificate, or the death looks suspicious (police called obviously) then the body is transport to the morgue by the mortuary ambulance (unmarked wagon, tendered service).

An autopsy happens after the doctor is contacted and he is not prepared to state a cause of death and obviously will not issue a Death Certificate.

Regards
Dave