Dead On Scene

Question 1

What is the expectation of the Pt & how should it be confirmed?

Answer 1

Pulseless & Apneic;

PEA/Asystole should be confirmed in 2 leads for at least 10 seconds

Question 2

Obvious Death Criteria

Answer 2

• Rigor mortis/lividity
• Decomposition
• Decapitation
• Transection of the torso
• Injuries incompatable with life
• Incineration (90% BSA)

= Withold resucitative efforts

Question 3

3 Causes of Cardiac Arrest that must be evaluated

Answer 3

1. Non Traumatic
2. Penetrating Trauma
3. Blunt Trauma

Question 4

Calling a Non Traumatic Arrest

Answer 4

Unwitnessed Arrest
(Prolonged downtime likely)
& PEA/Asystole

Witnessed Arrest
(prolonged downtime unlikely):
20 minutes of CPR w/
PEA and EtCO2 <20 mmHg
OR Asystole

Question 5

What should Penetrating Trauma Pt’s be evaluated for

Answer 5

Signs of Life:
- Reactive Pupils
- Heart Sounds
- Spontaneous Movement

Question 6

Calling a Penetrating Trauma Arrest

Answer 6

Pt is:
Apneic & Pulseless w/ Asystole or
PEA rate less than 40
&
Estimated time to Level I
Trauma Center is >15
minutes from loss of
signs of life

Question 7

Calling a Blunt Trauma

Answer 7

Patient is:
Apneic, pulseless w/ Asystole or
PEA rate less than 40

Question 8

When Resuscitative Efforts are withdrawn, what is next?

Answer 8

• Do not alter body condition in any way or remove equipment (lines, tubes, etc.)
• Call for Law Enforcement and secure the scene (if not already done)
• Document time of notification, arrival on scene, and badge number of
  responding personnel

Question 9

Special Situations that may Alter Plan of Attack

Answer 9

• Hypothermia (Submersion or Exposure) = OHCA AG
• <18 yrs = Consult Medical Direction

Question 10

What/Who can limit treatment/s?

Answer 10

Physical presence of:

• MOLTS/POLTS
• DNR
• Advance Directive
• Healthcare POA/Proxy