DNR

[RedAirplane]

I am a non transporting first responding EMT, so when this got posed, I wasn't sure what to answer.

You're transporting a patient on discharge from a hospital. The patient is on hospice and is going home to die with her loved ones. She has a valid DNR.

As you pull out of the hospital, she loses consciousness. You check and find no pulse and no breathing.

Obviously you do not start CPR/AED. But now what? Go back to the hospital? Call ALS? Call the cops? Continue transport? How does this sort of thing work?

 

[Flying]

As with so many other questions, it depends on the system: http://emtlife.com/threads/nobody-dies-in-an-ambulance.32317/

 

[DesertMedic66]

For my area, pull over where ever safe to do so and contact the coroner's office for further direction. They may want us to continue to the original destination, to the funeral home, or they will meet us at a location and take over possession of the body.

 

[ERDoc]

Maybe I am taking you too literal but if you just pulled out of the hospital pull back in and take the pt back. Someone with a monitor is going to need to confirm asystole or other rhythm incompatible with life.

 

[DesertMedic66]

Maybe I am taking you too literal but if you just pulled out of the hospital pull back in and take the pt back. Someone with a monitor is going to need to confirm asystole or other rhythm incompatible with life.

System dependent. In the presence of a DNR all we need is for the patient to be pulseless and apenic. Our hospitals don't accept dead bodies so they would not accept the return of the body.

 

[ERDoc]

I guess I am just a nice guy then. I would have no problem with the crew bringing the pt back. It makes more sense to tie up a bed in the morgue than an entire ambulance.

 

[zzyzx]

Take her back inside. What is the alternative? Take her home and drop off a dead body for the family?!

 

[EMSComeLately]

And this is why I ask questions of our transport coordinator and of the family before turning a wheel. I had one pass on me last week en route and continued to the house.

 

[Jason]

That close to the hospital, I would return the patient. Hospital would be much more equipped to handle care of the deceased and have the time and place for family to come -- I would think. If I were away from the hospital, maybe more at the destination -- I would follow field protocol and contact the Police/Coroner.

 

[RocketMedic]

As above- if within a few minutes of the hospital, nonemergent return and contact staff and coroner.