Did she do the right thing? - Tilted Forum Project Discussion Community

ngdawg · 02-25-2007, 07:18 PM

I found this incredible story in another forum and felt it so compelling, I wanted to open it for discussion. It's a long read-I edited out the unimportant aspects but kept some details in to show the grave situation this woman faced.

Quote:

Its 5 pm and you are kicked out for a 37 y/o male who's vehicle was struck by a large transport truck head on while driving on a highway @ ROS = 75 mph. The pt was driving a ford ranger.

You are the first ALS to arrive and there is only highway patrol to help.

You find the patient trapped in the truck by the dash. The firewall and dash are against his chest and abdomen and you can see his left leg underneath the firewall at an odd angle. There is no backseat in this vehicle.

The patient is A&O X 4 and talking to you. He says he feels pain in his chest and front of head (where you see significant bleeding).

History
none

Meds
none

Obvious Pertinent Physcial findings

- Pt is A&O x 4 now
- Pt is trapped with a 15 min ETA for extrication equipment
- Pt has difficulty breathing and head pain.

Vitals On arrival:
BP – 101/60 HR – 127 SAT – 91% r/a

On extrication:. We all have a good idea of what is going to happen in the BEST case scenario when we try to unpeel him out of the car - he is gonna crash secondary to the crush injuries. However, based on my experience with patients in situations like this --- it is going to be FAR worse. Imagine the unimaginable amount of kinetic energy that was transferred here.

Second --- there are 6 people on scene. Me, my partner, my pilot, the state trooper, patient #1 out of the big truck and patient #2 stuck in the little truck.
snip

We don't know what kind of condition patient #1 is in - I guess it depends on the size of his truck. But, I'm thinking that he may be injured, even though he’s walking around and coherent, as well (thinking kinetic energy potential again). Granted, he is probably not as bad off as patient #2 but ... are we just going to completely ignore him too? Your partner may have his/her hands full managing a second critical patient. Who knows? And who's to say that patient #1 isn't "more critical" and not entrapped in a vehicle? If we assume that patient #1 is okay, we may have another set of hands to assist in the improvised extrication attempt --- but they will be untrained hands, at best.

So, we've got a trooper. That's a good thing. However, chances are also good that it will be another untrained set of hands.

Me and my partner. Can't speak for my partner ... maybe s/he knows extrication, maybe not. I can speak for me. A LONG time ago, I was a volunteer FF in rural AR. I doubt that I could do it now. But, let's say that I can. So, we have two people to do the improvised extrication.

snip
... we have to get a GOOD patient assessment done on patient #2 (and don't forget that one of us has to assess patient #1, as well) - no one else is there to do it, so it boils down to me or my partner. We've talked about multiple large-bore IV placement, potential RSI, needle decompression of the chest, etc., I'm thinking oxygen NRBM - he is still breathing on his own and if I really want to do an RSI because of deterioration, I'd rather have him do his own nitrogen washout.

Back to the extrication issue --- okay, so let's say that we are FLIGHT DEMI-GODS and get all the ABC hoohah that needs to be done done (minus RSI) in 5 minutes. We have 10 more minutes until extrication arrives. My experience with extrication is that you don't just start cutting and banging - you gotta look at the problem first ... we are EXTRICATION DEMI-GODS too so this step is done in 3 minutes. Now the extrication crew is going to be there in 7 minutes. One of us is going to have to stay with the patient --- that leaves only one of us (plus, maybe two to three sets of untrained hands - without adequate extrication PPE) to do this job - without the right equipment
Another thought - we are not going to magicly "spring" the dash/firewall off him enough to pop him out quickly and easily. It is going to come off slowly no matter how he is extricated (pro vs. improv). He is going to start to crash prior to being completely released. I would really like my partner helping me and the patient at that point.

So, there is my rationale for waiting for the extrication equipment and the extra trained hands.

Now - remember I am half of the FLIGHT DEMI-GOD team ... we have 10 minutes +/- to figure out something to do. The patient is still AAOX4 with marginal V/S - of course they are going to get worse (recall insane amt of kinetic energy and crushed). He doesn't need to be intubated quite yet - probably soon, but provided that the O2 brought his sats up and he doesn't have a tension pneumo, he can probably wait another couple of minutes.

Okay, this is what seems to be the problem - I would ask him if there was anyone that he would like to talk to via cell phone. Parents, wife, whoever.

Why in the heck would I do that???

Cause we all know that chances of this guy coming out of this situation alive are slim to none. I know that I am thinking somewhat on the extreme pessimistic side of things,I still think that he no longer has any legs - that is just my experience and opinion talking. But, let's look at all of the facts --- extrication arrives in 10 minutes, they get started in 5-10 minutes, they manage to get the patient out in 15 minutes (they're REALLY good). 35-40 minutes gone. 5 minutes to get the guy loaded into the A/C and take-off. And 47 minutes to get to the trauma center. Plus, 3 minutes to get him into the perfectly prepared ED. 55 more minutes gone for a grand total of 85-90 minutes since you arrived at his side

He has a chance of survival - provided he has a managable lower half - but the chance is really really REALLY not good.

I'd like to be given the opportunity to call my significant other to say "I love you" potentially for the last time if I were in this situation. If all that we are doing is waiting for the extrication team at this point, I don't see why I shouldn't provide that opportunity to this guy. I'm not going to mince words with either him or his wife (or significant other --- PC crap again). He is probably going to crash and die as soon as (or soon after) we start the extrication. If he doesn't --- well, shame on me. I'll gladly accept that complaint letter any day.

No extrication equipment on hand and 5 minutes ETA for arrival

Cardiac Monitor is normal sinus tach currently at rate of 125.

Scene is safe no fuel leakage to speak of

When you touch the left leg you do not find a pulse. On further assessment it is NOT attached. Complete amputation mid femur left leg for sure. Cannot see right leg.

no obvious Arrhythmias

No feeling below the upper torso. You cant see where he is trapped at exactly.

He gives you his personal info. He has a wife and 2 small children in the area.

Currently you cannot see any IV sites.
On the passenger side if the vehicle you see alot of blood but cannot discern any actual body parts. It is unclear what is going on over there....

the patient tells you he really doesn’t feel much pain. He asks you if he will survive. What do you tell him?
My response was "Sir, I have to be completely honest with you. From what I can see and assess on you, your injuries are extensive and your condition is very very critical. It is a reasonable possibility that you might not survive this. I promise you we are going to do everything possible in our power, all of us, to help you make it through this but you very well may not." Then, got a phone, got him on the phone with his wife and children, focused my care on helping his psyche. He was still in “fight mode”.

Lindsey sets BLS and monitors, Bobby has rotors turning, PT is alert and responsive, states he refuses treatment, wants to see wife.
Wife en route.

Will arrive in less than 15 minutes

Pt states he has 7/10 pain in his abdomen.

Pt BP is 80/60 HR 140 Sat 92 % NRM

He would like something for pain now.

Lindsey has an EZ IO in his left shoulder.

Bobby monitored the dropping BP

We discuss pain med, I had to really give this one some thought. fact is, you may end up "codng" him in front of his wife anyways. Rescue is ready to go, I have them set up and do any preliminary things that would not further jeopardize his cardiovascular status(eg: "A "posts cut,roll the roof, get rams in place, etc) I explain to him that giving him pain med could in fact make matters worse, but if he insists ( and I assume he is competent to make the life choices) I would try some fentanyl. I tend to lean away from MSO4 in traumas anyways. As caregivers we have to be prepared for what might happen once his wife is at the scene and things go bad.

This was not easy for me or Lindsey to sit an wait doing only what we could to keep him alert and orientated, but unfortunately this is a fact of what we have chosen as our careers, you CANNOT save everyone, but everyone gets the best I have, the best the crew has and then some. I hate to loose, I have since day 1.

This is how it ended….
We dosed pt with increments of 100 of fentanyl. They also gave boluses of 200 cc of NS to keep the patient conscious. The wife was able to arrive and they had a moment alone to say goodbye.

The whole crew was very honest with the pt and the wife. They were told he would probably die when the compression of the vehicle was released. They appreciated this candor and spent his last moments holding each other saying goodbye.

When he passed out the extrication crew finished the job (they prepped the car while wife was en route). On extrication, the pt went into PEA -> A systole.

His pelvis was crushed severely. The second the compression was gone his blood volume dumped into his pelvis and he died.

We flew Pt. wife to hospital to await the body being ground transported. I sat with her through the flight and during the wait. She asked I accompany her to the morgue for viewing, I did so. I told her I would be in the flight office when she was done if there was anything else needed
After the preliminaries were done, she returned to the flight office, hugged us all and kissed Lindsey and I on the cheek whispering to all a sorrowful “thank you”

In a subsequent letter from the wife, she stated:
“I could not say enough good things about this crew. Especially Lindsey and the one they called “Angel” Truly, those 4 are amazing providers who put the QUALITY of life before QUANTITY, something often forgotten in the rush of emergency medicine.

after a 5 day grounding I was reprieved and vinicated, will post the dieciplinary hearing findings after some discussion on the events first.

She was grounded for calling the wife, in short. But thoroughly vindicated for being above and beyond her call of duty.

I would hope that, if I was ever in that situation, either as the crash victim or the spouse, that the EMT's would have the presence of mind and the soul to contact my loved one or myself.
My other feeling on this is that it should never have even been up for review, but should be protocol-if you know your victim will die once extricated, why would you NOT call next of kin to arrive?
Was she right in what she did? Should she have been disciplined? If you found yourself in a life or death situation, would you want her there? And, if you are an EMT or police officer, are you allowed to take this action? Would you?

ShaniFaye · 02-25-2007, 07:34 PM

While I know nothing of EMS protocol, on the "human" side I applaud and support what she did

Ourcrazymodern? · 02-25-2007, 07:41 PM

Dumbfounded and ignorant of protocols I'd very much wish to see beloveds before I died, if possible. It seems...mean-spirited to take that away if that's all there was to give.

shakran · 02-25-2007, 07:48 PM

Agreed. She did the right thing. Hands down.

I had a similar thing happen to me way back in the beginning of my career. Rolled up on a car vs semi, had the camera out, and was already rolling before I realized no EMS was there (I was a total rookie). Locked the camera down on a wideshot and ran in to start first aid if necessary. Fortunately they survived (don't ask me how) and weren't even that injured, so I went back to the camera and kept shooting.

Got yelled at for it. I should never influence events. What the hell was I thinking. Etc etc. Like I said I was green as hell so I just took it but now that I've got *cough* years under my belt, I wouldn't do anything differently today either. There are times when you have to put down the rules and regulations of your profession and start being human.

ShaniFaye · 02-25-2007, 07:51 PM

You hear so many people say..."if I'd just had the chance to say goodbye, If they had only been able to hear I love you one more time"

She gave this couple that chance, for the wife thats two less "if only's" she wont have to regret

ngdawg · 02-25-2007, 08:34 PM

Twice in 14 months, we'd gotten those dreaded calls-that a loved one died suddenly and unexpectedly. The first, my brother-in-law of a drug overdose, alone in an empty building in downtown Philly and the second, my father-in-law, on vacation in Florida of a heart attack.
When I hear of people saying they'd prefer quick passings, I think of those two times-no goodbyes, no settling affairs, no making peace.
My good friend recently lost his mother to a lingering disease; each month he'd make the 6 hour trip and stay for a few days with her. He spent his first Christmas in 10 years with her; he helped out, he made peace, he said goodbye each time, thinking it'd be the last time. Her death wasn't easier to bear, but easier to accept.
When my uncle, my father's only brother and his best friend, died two days before Christmas many years ago, he told my cousin to not call my father because he didn't want to 'ruin his holiday'....over 20 years later we still speak of that stupid decision.

Xazy · 02-25-2007, 09:01 PM

She did the right thing. In our community there is a volunteer ambulance company, and I know one of the heads of it. So I asked him his thoughts on it, and it would violate protocal, but he did admit he probably would make the call though (or so he hopes).

analog · 02-25-2007, 10:27 PM

For me personally, I would want to call a family member/etc to say goodbye, but I would not want them present. At all. As much as I might love someone, want to hold their hand one more time, let the last thing I see be their face- I would not want my death to be the last thing THEY see.

If the person is not already dead, here's why the protocol is what it is...

You really, REALLY don't want to see a loved one code in front of you. I promise you. No amount of "preparing" can assuage you from having to see a true trauma code. This guy seemed to just lose all his blood volume when the compression was released, so he didn't go through a huge production, more than likely. If he did, she'd have detailed that. When a person has a heart attack or starts to code from injuries like the guy in the story, the things the body goes through are not something you want to see.

When a person's heart is failing and they are dying because of blood loss, etc., they vomit, gag, can spasm a lot, they piss and defecate, and make terrible noises. It is not like what you see on TV, where they just shock them and watch the monitor and they die.

So here's the thing to consider:

Do you want to see your loved one naked (yes, they are stripped unless it is literally impossible to remove the clothing), gagging and vomiting as they die, possibly flailing a bit if they haven't fully lost consciousness yet, maybe screaming... there's a sheet over their gential area, but it's mostly there because as they die they will piss and shit everywhere. If they're male, they will normally have an erection while coding, especially if spinal injury was incurred.

Trust me- you do not want to see your loved one go through a code. You may get to say "goodbye" before they go, but your last memory will be them going through the terrible ordeal I outlined above.

This is what the wife may have arrived to see, had the guy started dying less pleasantly than he eventually did.

That's why it's against protocol, because of how terribly traumatic it is. Professional EMS providers can be deeply affected by the right code, let alone people who actually knew the patient.

Sultana · 02-26-2007, 09:31 AM

That's a toughie, to put it mildly.

The write-up didn't say that the wife witnessed the actual passing, just that they talked and held each other until the patient passed out. I would certainly want to hold the hand of my loved one until their last conscious moment. Fortunately for them, his passing out preceeded his passing on. Hopefully the EMTs could lead her away afterwards to spare her the potential violence of his death.

I'm glad she didn't bring the kids though.

But being there for your husband when he dies...that's what you do for them, if you are able to. People have witnessed death since life first started. Yes it's traumatic, but so would dying alone, I would imagine. The *least* I could do for my husband is to hold his hand while he died. Come on.

Yikes. Gettin' teary here.

This situation reminds me of that Mel Gibson movie...Signs? Similar thing happened to the main character. I was hoping it was overly dramatized and uncommon.

ShaniFaye · 02-26-2007, 09:44 AM

Sultana, THANK YOU, I was driving my self nuts last nite trying to remember where I had seen a similar situation

ngdawg · 02-26-2007, 10:02 AM

Quote:

Originally Posted by Sultana

That's a toughie, to put it mildly.

The write-up didn't say that the wife witnessed the actual passing, just that they talked and held each other until the patient passed out. I would certainly want to hold the hand of my loved one until their last conscious moment. Fortunately for them, his passing out preceeded his passing on. Hopefully the EMTs could lead her away afterwards to spare her the potential violence of his death.

I'm glad she didn't bring the kids though.

But being there for your husband when he dies...that's what you do for them, if you are able to. People have witnessed death since life first started. Yes it's traumatic, but so would dying alone, I would imagine. The *least* I could do for my husband is to hold his hand while he died. Come on.

Yikes. Gettin' teary here.

This situation reminds me of that Mel Gibson movie...Signs? Similar thing happened to the main character. I was hoping it was overly dramatized and uncommon.

I got teary as well-took me a while after reading that to compose myself, ask about posting and how....
The first thing I thought of after reading this was an episode of 'Homicide'-Vince D'Onofrio played a man shoved in a subway station who got trapped between the train and the platform. In a striking similarity to this real life event, he was crushed beyond hope from the pelvis down, but alert and the police kept him company waiting for the rescue squad and for the equipment to lift the train, knowing that he would die as soon as that happened. That episode stuck with me because of the 'what would I want in that case?' thinking behind it. So, I guess it's not just a scriptwriter's exercise.

f6twister · 02-26-2007, 10:03 AM

As a former EMT, I can tell you that making that type of phone call would not have been permitted. My job was to treat the injuries the best I could. Thankfully this scenario didn't come up during my time as an EMT.

However, that doesn't mean that the police officer on scene couldn't have that call made. As a current 911 dispatcher, I've had to make these calls to the spouses, parents and children of those critically injured in accidents. They always ask the same question...how bad is it? In most of these cases, I don't know the exact injuries but I tell them to either get to the scene or hospital (depending on the circumstances) as soon as possible. They have always known what I meant.

The only time I was surprised by one of these calls was by the father of a critically injured son. The son rolled his car after losing control on a curvy road at night. It was his 3rd time caught drunk driving. I happened to know the injuries on this call and relayed that information along tell him that it isn't looking good so he should get to the hospital as soon as possible. His response..."I'm still in bed and need to shower first so it might be a while before I get there". I never found out how long (if ever) it took for him to get there. I still wonder if he was either just tired of his son's drunk driving or if he was just too scared to see his son in that condition. I'll never know.

Grasshopper Green · 02-26-2007, 03:16 PM

Having witnessed a loved one die and go through similar things that analog described, I can honestly say that if my hubby were in a similar situation...I'd want to be there with him.

ShaniFaye · 02-26-2007, 03:23 PM

I can quite honestly say, if it meant Dave hearing me say I loved him one last time, you'd have to do me bodily harm to keep me away

jorgelito · 02-26-2007, 04:58 PM

Thanks Analog for providing another perspective. This thread was in danger of running away emotionally without examining the facts.

No matter what, it is definitely a tough decision and I certainly don't envy anyone who would have to make it.

Lady Sage · 02-26-2007, 05:33 PM

I nominate the woman for sainthood.

Should Pan be in that situation youre damn straight I would want to know. I would want to be there. One last kiss, one last goodbye, one last I love you.

If I were pinned, I would want to call Pan and the same thing. One last I love you, one last goodbye.

Disciplinary action? People arent numbers, they are people. It is high time more people treated us like we should be treated.

BRAVO!

SirLance · 02-26-2007, 05:44 PM

Right call, no question. I've seen enough young men die who were denied last moments with their families, and the peace that can bring to not only the young men, but the families as well.

Lady Sage · 02-26-2007, 05:50 PM

Come to think of it, had Pan been in that situation and I had not been called when I could have been... I would have thrown a hissy fit the likes of which have never been seen before. Hell hath no fury like a pissed off and wronged Sage. I would have done everything I could have done to own someone and changed some serious policies.

Gilda · 02-26-2007, 06:40 PM

First, the crushed victim who will live just long enough to say goodbye to a loved one is an old urban legend. In addition to Signs and Homocide, it shows up in an episode of 3rd Watch (car accident combined with a bridge collapse) and at least one other show I can't place right now, with a man crushed between a delivery truck and a loading dock.

I'm not saying that's what this is, and it certainly doesn't hurt to accept the story as true for the sake of discussion, so assuming that it is . . .

I ask myself what I would have wanted had I been conscious and about to die at the bottom of that ditch. I'd want the chance to say goodbye to Grace and Sissy. Not to have them there to see it, but to talk to her and say goodbye. As it was, Sissy was there most of the first day and both of them the day following when I was still in a coma.

I ran it by Grace, a former EMT, and her response was, paraphrased:

"The job is to treat the patient, get him stable for transport if further treatment is required, and get him to the nearest appropriate treatment facility as soon as possible. Having a spouse there during critical treatment usually causes problems rather than helping in most situations. I've never been in that specific situation, so I have no way of knowing exactly what I'd have done, but contacting family is generally the the job of the police, hospital, or dispatch. I might have given him a chance to say goodbye, but waiting for the wife to get there so she could see her husband die a violent and messy death? Nope."

ngdawg · 02-26-2007, 08:07 PM

Three of the things I deleted were the links to the pictures of the accident; another I edited out was the technical stuff, ie; patient vitals, so this is not(in all likelihood) made up. The man, in essence, bled to death once the pressure, through the extrication, was removed. The woman is an EMT with an emergency response flight team. This is the result of her review:

Quote:

There were a bunch of medical procedure questions, all were found within parameters and scope of the situation.
Then a few questions of personal issues, did I feel I was gaining something by what I did, would I have been better off to “rush” the extriction, would he have had a better chance sedated. I answered them all the same way I would have that day, NO, I was not gaining anything, NO, if the extrication was rushed it would have worsened Pt condition which was already deteriorating rapidly, sedation would have comatose the patient.
I ran down a list of meds, pressures, vitals etc. and followed with this Pt’s will to fight to stay with me till his wife got there.
I got a very disturbing stare form the flight admin for that last comment, “stayed with YOU?” Where Terry(her pilot) interrupted with “yes her, she was the one managing to keep her tome(sic) calm and level, so Lindsey could try and see the extent of injuries and possible extended trauma from any sort of partial extraction.”
There was a long silence and we were dismissed.

At 8:30 PM , I got a call at the flight office, “although your interpretation of the oath you signed is not particularly the same as all on the board, you and your crew have shown that the essence of protocol in the field is nothing more than a judgment call, not just here, but in review of other random drawn cases. Your crew should be commended for their diligence in making this man’s last moments, and his families, ones they can use to ease their grief, this matter is concluded with the exception of the boards heartfelt thanks, and apology. Please feel free Carol, to resume your schedule at your earliest convenience.” (Jonathon P Telleratsen, administrative director of operations)

A friend of ours had a father who was dying and had to be put on an artificial respirator. He was alert and coherent. The doctors spoke with him and the family, stating there wasn't much more in treatment they could do-they recommended sending him home with a respirator, saying he could live a few more months. He declined. So they called everyone, set a time that the respirator would be shut off. Surrounded by family, our friend (his daughter), his wife, they all said their goodbyes, left the room and he was shut down. He died within minutes.

Gilda · 02-27-2007, 04:32 AM

Thank you for the update.

It's good to hear that she wasn't penalized much for her acts of kindness.

jorgelito · 02-27-2007, 02:03 PM

Gilda, thanks for giving us Grace's opinion on the matter to help supplement Analog's professional opinion. It helps to bring a little balance to this emotional discussion.

I don't think any of us can truly appreciate the EMT's side of things nor the victim and victim's family's side of things without firsthand experience.

For those so adamant about one last farewell, that may not even be possible given the conditions described. Plus the gruesome acts surrounding the deaths may not be the best scene for the families involved. I'm not so sure I would want my family to see me convulsing, vomiting, bleeding, and defecating all over myself nor would I want to see another go through the same thing. I'm sure it's not so nice and neat like in the movies.

But then again, maybe I would. The finality of it all makes it a tough decision.

ngdawg · 02-27-2007, 10:10 PM

Another thought to this occurs to me that, when a paramedic assesses a situation and the patient is coherent, how much of the patient's wishes is he/she supposed to consider? If there's a DNR (and many times it can't be found when needed, as in the case of my great-aunt, who was put on life-support after a fall because no one could locate her DNR instructions), then I would presume that paramedics would stop life-saving or life-prolonging stratagies. But what if the patient says 'no drugs', even if those drugs helped save his/her life? Then we come to something like this, where he wanted to not be given them until they got hold of his wife.
For those who are or were EMT's-would you then be obligated to make that contact if it was determined that nothing would progress until it's done?
Another question-is it normal for EMT's to visit with their patient or family afterwards? When I was taken by paramedics to the hospital, they later stopped by to see how I was faring, which I thought was a nice gesture.

Menoman · 02-27-2007, 11:11 PM

How about the amazing amount of pressure an EMT has in a situation like this... trying his best to save the life of someone he doesn't think has any chance.

Compounded by the family being right there witnissing his every move. Crying, probably screaming, possibly screaming at him to please save his life.

little_tippler · 02-28-2007, 02:05 AM

Every situation is different. I don't think she did anything wrong, especially if in the end the wife was grateful. It may not be part of her job, but if in this situation it did no harm, then I don't see why se can't be human. I see the point made by Analog and I think for some cases, it's perhaps not the right thing to do. It's not part of the job. But every case will call for different decisions.

analog · 02-28-2007, 04:20 AM

Quote:

Originally Posted by ngdawg

Another thought to this occurs to me that, when a paramedic assesses a situation and the patient is coherent, how much of the patient's wishes is he/she supposed to consider? If there's a DNR (and many times it can't be found when needed, as in the case of my great-aunt, who was put on life-support after a fall because no one could locate her DNR instructions), then I would presume that paramedics would stop life-saving or life-prolonging stratagies. But what if the patient says 'no drugs', even if those drugs helped save his/her life? Then we come to something like this, where he wanted to not be given them until they got hold of his wife.

If a patient is coherent and it's judged that they're competent to made their own decisions regarding their medical care, they can opt out of any treatment(s) at any time. Also, a DNR doesn't stop life-saving measures until the heart stops (or other direction as stipulated in the Do Not Resuscitate order). Once the heart stops of its own accord, then there is no attempt to bring it back. People can also have a living will that further stipulates the level of care they wish to have when attended by EMS. This can say anything up to and including specific drugs/interventions they don't wish to be used on them.

Quote:

Another question-is it normal for EMT's to visit with their patient or family afterwards? When I was taken by paramedics to the hospital, they later stopped by to see how I was faring, which I thought was a nice gesture.

Many times, the medic team will take most of their patients to one hospital, whatever is closest to them. While they're there, it's not uncommon for them to take a quick walk and "check up on" other patients they transported there earlier. I know on one shift, we kept going to this one guy we'd transported in the morning, to see his progress for the rest of the day- I think we saw him twice more and then after that, he'd been discharged. I think the family appreciated the attention to/interest in his progress.

Demeter · 03-01-2007, 08:37 AM

My brother tried to resuscitate my Dad as he was passing, and it haunts him to this day that he saw my Dad in that position, and his failure to prevent the inevitable. The experience left him broken and guilt-ridden. That sticks in my mind as a reason to not be there.
I did have the chance to say goodbye to a loved ones twice, shortly before they passed, but wasn't present at the exact moment of death. I think I prefer it that way.

I don't think I'm strong enough to 'share' someone's death...if that makes any sense.

Gilda · 03-01-2007, 08:46 AM

Quote:

Originally Posted by ngdawg

Another question-is it normal for EMT's to visit with their patient or family afterwards? When I was taken by paramedics to the hospital, they later stopped by to see how I was faring, which I thought was a nice gesture.

The EMTs who treated me at the scene and in the process saved my life and saved my arm visited with Grace and Sissy while I was still unconscious and with me briefly a couple of times after I was conscious again.

Grace says it's common to check up on patients at the hospital after subsequent runs when not going immediately back out.

MSD · 03-02-2007, 09:32 AM

This reminded me of a horrible story I read on another forum in an EMT's thread about his job. Sometimes you just can't do the right thing.

Link to the original post. If you want more stories about real EMT work, ranging from funny to tragic, check out the whole thread. If the thread stops displaying and you get the message telling you to register, you can clear your browser's cookies and continue on. Note that the forum name "Comedy Goldmine" is a bit deceiving, and it's for all great threads, not just the funny ones.

Quote:

Guilt

“3-12, 3-12”
“3-12, on the air – where to, CMED?”
“3-12, Humphrey Avenue, pediatric anaphylaxis – bystanders report the patient is down and unresponsive.”
“3-12, en route.”

We were dispatched to deal with a boy who had gotten stung by several bees. At least that’s what we figured because when we arrived on scene the boy was unconscious and had visible chest rise. He was red, blotchy, and his lips and nail beds were certainly more purplish than I was comfortable dealing with. A by stander told us the boy was seven, and his parents were at work.

“3-12, on scene – do we have a medic?”
“Hold 3-12… Negative, medics from the city are on zero-point.”
“Roger, get me med control when you can.”

I look at the patient, he’s cyanotic. I see the boy’s chest rising rapidly, but he’s not breathing. His airway has closed up, he’s trying to breathe but he couldn’t – this wasn’t going to be pretty. My partner pops in an oropharyngeal adjunct and starts bagging, it doesn’t do any good, and the boy’s lungs were locked behind walls of swollen airway. I turn to my radio; the CMED dispatcher dropped a different tone to alert that they had a doctor on the horn.

“This is Doctor Jones.”
“Hey Doc, 3-12 – have a seven year old boy, multiple bee stings, bad reaction, fully compromised airway. Can we hit him with an Epi Jr.?”
“3-12, is he breathing?”
“Trying, airway’s shut.”
“Ok, 3-12, administer .15 mg epinephrine via an Epi Jr. Report back after 5 minutes.”
“.15 mg epi via Epi Jr., talk in 5. Roger.”
“Doctor Jones out.”

I grab the EpiPen Jr. from our jump bag and push it firmly against the patient’s thigh. I wait until the window in the auto-injector is red and toss it aside. I grab the boy in my arms and run to the bus, my partner hops in the front. A police officer had shown up on scene several seconds after we had – he told me he would grab all the information he could on the patient and meet us at the hospital.

The kid’s airway wasn’t opening, I continue to try and bag. He’s purple and splotchy from the nipples up. He’s crying, he’s trying to sob but the air just won’t come. I get the doctor on the radio again.

“3-12, how’s he doing?”
“Airways still bad, nothing’s passing through.”
“How much does he weigh?”
“Approximately twenty, twenty-five kilograms.”
“3-12, hit him with another Jr if you have it – contact me again in five”
“Roger, administer another Epi Jr., talk to you in five.”
“What’s your ETA?”
“About ten, too long.”

I administer the second EpiPen Jr, bringing the total epinephrine count the boy had been dealt to .3 mg, the same as an adult EpiPen. He’s still not responding, he’s not crying anymore – staring into oblivion. I check his carotid pulse – tachycardic, his heart is working hard trying to compensate, yet failing miserably. I keep trying to bag him, hoping that after the second dose his airway would start to open up. After several minutes, I gave up trying, it wasn’t opening. I grab the radio – I grab a scalpel and an IV catheter. We had been trained to do cricoidotomies and tracheotomies in our EMT class, even though it was well outside of our scope of practice.

“3-12, talk”
“Doc, no response to the second dose. Let me do a cricoidotomy.”
“3-12, you’re not a medic, I don’t know if you can do it right.”
“Doc, we’re trained to do it in EMT class – I need to do something or I’ll be bringing a body in to your ER.”
“Just keep trying to ventilate; it’s all you can do.”
“Doc.”
“Listen to me 3-12, I know I’m tying your hands – but it’s the way it has to be.”

I put a pulse-oximeter on the boy’s finger; I continue trying to bag him. He has a blood-oxygen saturation of thirty, I watched as his pulse dwindled. I kept looking to the scalpel, did I want to try and save this boy? Why the hell wasn’t I doing everything I could? I was letting this boy die – letting him suffer – no, forcing him to suffer. With one twitch of my wrist, I could ventilate him properly; I could bring sweet oxygen-rich air to the darkest depths of his lungs. Who was I to deny this child life? If I helped him, I’d lose my license and my job – if I let him die, what good am I?

The error tone of the pulse-ox attracts my attention, the number next the section labeled “pulse” consisted of six lines arranged in a circle. The heart, oxygen starved and dying finally gave out. I call for my partner to inform the hospital that our patient is in cardiac arrest. We’re about two minutes out, I slide the pediatric short-board under him and I start compressions. I had to do something.

I can rationalize that the boy had been oxygen deprived for too long, his brain and vital organs were no doubt severely damaged – the big question would become whether it was worthwhile to save him. Would his quality of life be worth saving? In the back of my head, I knew the boy was better off dead, but last time I checked things in the back often get the least attention.

The doctor meets us at triage with two techs and a nurse, they grab the gurney from us and pull him towards room one. I’m trembling, I’m angry at myself for not performing the cricoidotomy. I have a cigarette.

The police officer who met us on scene comes to the ER as I’m working on my third, I can’t fill out the paperwork until I get the information from him.

“How’s he doing boss?”
“Doctor pronounced him about ten minutes ago.”
“poo poo, seven years old. I’m sorry bro.”
“Bad stuff happens all the time.”
“Got that right, family is coming… Here’s all the info.”

As I perused the information and filled out my forms, I morbidly thought about how little Andrew learned a valuable lesson today. I imagined a grotesque caricature of Big Bird explaining the importance of breathing, and how not breathing is bad.

When my partner nudged my shoulder, I snapped back to reality. My vision was blurry and my cheeks had a few wet streaks.

“Matt, big accident. We need to roll dude.”
“Alright, let me just drop this info off with triage.”
“I’ll be in the bus.”

I can’t even cry if I wanted to – because when I need to, there’s no time.

Over the past few years I've made a conscious decision to make sure that nobody in my presence falls victim to the bystander effect. I don't care how many people are around, I will personally call 911 anytime it's appropriate unless I'm explicitly told that someone else already has. On several occasions when I've witnessed accidents and near-accidents I've had my phone out, 911 punched in, and my finger on the send button before all the cars involved had stopped moving. Once I know the police and paramedics are on their way I'm the first out of my car running to see if I can do anything. Maybe if people see me running to try to help they'll be inspired to do what they can, maybe I'll be the only one. All I know is if people need help it isn't safe to assume that someone else will do it.

Based on the story I came to the conclusion that if I ever came across a situation like that and knew what was happening, I would tell the EMT that since he couldn't do it I was going to take his scalpel, and that he could either tell me exactly where to cut or let me figure it out myself. I'm trained in First Aid (and I've read up on how to do a tracheotomy,) and CPR, so I'm confident that I could do it if I needed to, and I don't think anyone would tell him he did the wrong thing if a gigantic man ran up and demanded instructions. Maybe I'd get in trouble for interfering, but the kid would still be alive.

ngdawg · 03-02-2007, 10:00 AM

When my father-in-law died, he and the MiL were on vacation in Florida. He had dropped over-my mother-in-law heard a thud, came running to where he had been sitting, knew what'd happened and began pounding on his chest while calling the front desk. They had no defribillator hand, no one on staff knew CPR; they called for an ambulance.
Because she'd been pounding on him, the EMT's were obligated to 'continue' resuscitation efforts. Because the EMT's had continued resuscitation efforts, the ER was obliged to do so....all 'protocol'. The man was dead before he hit the floor. Mom had be been pounding on him, screaming at him not to die on her-but to the EMT's, it was 'resuscitation'.
As lay-people, we're in a damned-if-you-do, damned-if-you-don't position. If you run to help, whether you know CPR or not, you could be held liable for any failures. If you stand by and do nothing, you could be held under 'good samaritan' laws or feel guilt for not being able to assist. And, if it's a loved one and you go into panic mode, it starts a chain reaction like above.

Carno · 03-02-2007, 10:06 AM

Quote:

Originally Posted by MrSelfDestruct

Based on the story I came to the conclusion that if I ever came across a situation like that and knew what was happening, I would tell the EMT that since he couldn't do it I was going to take his scalpel, and that he could either tell me exactly where to cut or let me figure it out myself. I'm trained in First Aid (and I've read up on how to do a tracheotomy,) and CPR, so I'm confident that I could do it if I needed to, and I don't think anyone would tell him he did the wrong thing if a gigantic man ran up and demanded instructions. Maybe I'd get in trouble for interfering, but the kid would still be alive.

Or maybe dead but with a mutilated throat.

MSD · 03-04-2007, 10:25 AM

Quote:

Originally Posted by Carno

Or maybe dead but with a mutilated throat.

The kid would be dead anyway if nobody tried. I don't think an EMT would refuse to tell me where to make the incision, and like I said, I've read enough about how to do a tracheotomy that I'm pretty sure I could do it in an emergency.

02-25-2007, 07:34 PM	#2 (permalink)
ShaniFaye Submit to me, you know you want to Location: Lilburn, Ga	While I know nothing of EMS protocol, on the "human" side I applaud and support what she did __________________ *I want the diabetic plan that comes with rollover carbs. I dont like the unused one expiring at midnite!!*

02-25-2007, 07:41 PM	#3 (permalink)
Ourcrazymodern? still, wondering. Location: South Minneapolis, somewhere near the gorgeous gorge	Dumbfounded and ignorant of protocols I'd very much wish to see beloveds before I died, if possible. It seems...mean-spirited to take that away if that's all there was to give. __________________ BE JUST AND FEAR NOT

02-25-2007, 07:51 PM	#5 (permalink)
ShaniFaye Submit to me, you know you want to Location: Lilburn, Ga	You hear so many people say..."if I'd just had the chance to say goodbye, If they had only been able to hear I love you one more time" She gave this couple that chance, for the wife thats two less "if only's" she wont have to regret __________________ *I want the diabetic plan that comes with rollover carbs. I dont like the unused one expiring at midnite!!*

02-25-2007, 08:34 PM	#6 (permalink)
ngdawg peekaboo Location: on the back, bitch	Twice in 14 months, we'd gotten those dreaded calls-that a loved one died suddenly and unexpectedly. The first, my brother-in-law of a drug overdose, alone in an empty building in downtown Philly and the second, my father-in-law, on vacation in Florida of a heart attack. When I hear of people saying they'd prefer quick passings, I think of those two times-no goodbyes, no settling affairs, no making peace. My good friend recently lost his mother to a lingering disease; each month he'd make the 6 hour trip and stay for a few days with her. He spent his first Christmas in 10 years with her; he helped out, he made peace, he said goodbye each time, thinking it'd be the last time. Her death wasn't easier to bear, but easier to accept. When my uncle, my father's only brother and his best friend, died two days before Christmas many years ago, he told my cousin to not call my father because he didn't want to 'ruin his holiday'....over 20 years later we still speak of that stupid decision. __________________ Don't blame me. I didn't vote for either of'em.

02-25-2007, 10:27 PM	#8 (permalink)
analog Banned	For me personally, I would want to call a family member/etc to say goodbye, but I would not want them present. At all. As much as I might love someone, want to hold their hand one more time, let the last thing I see be their face- I would not want my death to be the last thing THEY see. If the person is not already dead, here's why the protocol is what it is... You really, REALLY don't want to see a loved one code in front of you. I promise you. No amount of "preparing" can assuage you from having to see a true trauma code. This guy seemed to just lose all his blood volume when the compression was released, so he didn't go through a huge production, more than likely. If he did, she'd have detailed that. When a person has a heart attack or starts to code from injuries like the guy in the story, the things the body goes through are not something you want to see. When a person's heart is failing and they are dying because of blood loss, etc., they vomit, gag, can spasm a lot, they piss and defecate, and make terrible noises. It is not like what you see on TV, where they just shock them and watch the monitor and they die. So here's the thing to consider: Do you want to see your loved one naked (yes, they are stripped unless it is literally impossible to remove the clothing), gagging and vomiting as they die, possibly flailing a bit if they haven't fully lost consciousness yet, maybe screaming... there's a sheet over their gential area, but it's mostly there because as they die they will piss and shit everywhere. If they're male, they will normally have an erection while coding, especially if spinal injury was incurred. Trust me- you do not want to see your loved one go through a code. You may get to say "goodbye" before they go, but your last memory will be them going through the terrible ordeal I outlined above. This is what the wife may have arrived to see, had the guy started dying less pleasantly than he eventually did. That's why it's against protocol, because of how terribly traumatic it is. Professional EMS providers can be deeply affected by the right code, let alone people who actually knew the patient. Last edited by analog; 02-25-2007 at 10:39 PM..

02-25-2007, 07:48 PM	#4 (permalink)
shakran Tone.	Agreed. She did the right thing. Hands down. I had a similar thing happen to me way back in the beginning of my career. Rolled up on a car vs semi, had the camera out, and was already rolling before I realized no EMS was there (I was a total rookie). Locked the camera down on a wideshot and ran in to start first aid if necessary. Fortunately they survived (don't ask me how) and weren't even that injured, so I went back to the camera and kept shooting. Got yelled at for it. I should never influence events. What the hell was I thinking. Etc etc. Like I said I was green as hell so I just took it but now that I've got cough years under my belt, I wouldn't do anything differently today either. There are times when you have to put down the rules and regulations of your profession and start being human.

02-25-2007, 09:01 PM	#7 (permalink)
Xazy People in masks cannot be trusted Location: NYC	She did the right thing. In our community there is a volunteer ambulance company, and I know one of the heads of it. So I asked him his thoughts on it, and it would violate protocal, but he did admit he probably would make the call though (or so he hopes).

02-26-2007, 09:31 AM	#9 (permalink)
Sultana Falling Angel Location: L.A. L.A. land	That's a toughie, to put it mildly. The write-up didn't say that the wife witnessed the actual passing, just that they talked and held each other until the patient passed out. I would certainly want to hold the hand of my loved one until their last conscious moment. Fortunately for them, his passing out preceeded his passing on. Hopefully the EMTs could lead her away afterwards to spare her the potential violence of his death. I'm glad she didn't bring the kids though. But being there for your husband when he dies...that's what you do for them, if you are able to. People have witnessed death since life first started. Yes it's traumatic, but so would dying alone, I would imagine. The least I could do for my husband is to hold his hand while he died. Come on. Yikes. Gettin' teary here. This situation reminds me of that Mel Gibson movie...Signs? Similar thing happened to the main character. I was hoping it was overly dramatized and uncommon. __________________ "Love is a snowmobile racing across the tundra and then suddenly it flips over, pinning you underneath. At night, the ice weasels come." - Matt Groening My goal? To fulfill my potential.

02-26-2007, 09:44 AM	#10 (permalink)
ShaniFaye Submit to me, you know you want to Location: Lilburn, Ga	Sultana, THANK YOU, I was driving my self nuts last nite trying to remember where I had seen a similar situation __________________ *I want the diabetic plan that comes with rollover carbs. I dont like the unused one expiring at midnite!!*

02-26-2007, 10:03 AM	#12 (permalink)
f6twister Addict	As a former EMT, I can tell you that making that type of phone call would not have been permitted. My job was to treat the injuries the best I could. Thankfully this scenario didn't come up during my time as an EMT. However, that doesn't mean that the police officer on scene couldn't have that call made. As a current 911 dispatcher, I've had to make these calls to the spouses, parents and children of those critically injured in accidents. They always ask the same question...how bad is it? In most of these cases, I don't know the exact injuries but I tell them to either get to the scene or hospital (depending on the circumstances) as soon as possible. They have always known what I meant. The only time I was surprised by one of these calls was by the father of a critically injured son. The son rolled his car after losing control on a curvy road at night. It was his 3rd time caught drunk driving. I happened to know the injuries on this call and relayed that information along tell him that it isn't looking good so he should get to the hospital as soon as possible. His response..."I'm still in bed and need to shower first so it might be a while before I get there". I never found out how long (if ever) it took for him to get there. I still wonder if he was either just tired of his son's drunk driving or if he was just too scared to see his son in that condition. I'll never know. __________________ A little rudeness and disrespect can elevate a meaningless interaction to a battle of wills and add drama to an otherwise dull day. Calvin

02-26-2007, 03:16 PM	#13 (permalink)
Grasshopper Green ...is a comical chap Location: Where morons reign supreme	Having witnessed a loved one die and go through similar things that analog described, I can honestly say that if my hubby were in a similar situation...I'd want to be there with him. __________________ "They say that patriotism is the last refuge to which a scoundrel clings; steal a little and they throw you in jail, steal a lot and they make you king" Formerly Medusa

02-26-2007, 03:23 PM	#14 (permalink)
ShaniFaye Submit to me, you know you want to Location: Lilburn, Ga	I can quite honestly say, if it meant Dave hearing me say I loved him one last time, you'd have to do me bodily harm to keep me away __________________ *I want the diabetic plan that comes with rollover carbs. I dont like the unused one expiring at midnite!!*

02-26-2007, 04:58 PM	#15 (permalink)
jorgelito All important elusive independent swing voter... Location: People's Republic of KKKalifornia	Thanks Analog for providing another perspective. This thread was in danger of running away emotionally without examining the facts. No matter what, it is definitely a tough decision and I certainly don't envy anyone who would have to make it.

02-26-2007, 05:33 PM	#16 (permalink)
Lady Sage Mistress of Mayhem Location: Canton, Ohio	I nominate the woman for sainthood. Should Pan be in that situation youre damn straight I would want to know. I would want to be there. One last kiss, one last goodbye, one last I love you. If I were pinned, I would want to call Pan and the same thing. One last I love you, one last goodbye. Disciplinary action? People arent numbers, they are people. It is high time more people treated us like we should be treated. BRAVO! __________________ If only closed minds came with closed mouths. Minds are like parachutes, they function best when open. It`s Easier to Change a Condom Than a Diaper Yes, the rumors are true... I actually AM a Witch.

02-26-2007, 05:44 PM	#17 (permalink)
SirLance Junkie Location: In the middle of the desert.	Right call, no question. I've seen enough young men die who were denied last moments with their families, and the peace that can bring to not only the young men, but the families as well. __________________ DEMOCRACY is where your vote counts, FEUDALISM is where your count votes.

02-26-2007, 05:50 PM	#18 (permalink)
Lady Sage Mistress of Mayhem Location: Canton, Ohio	Come to think of it, had Pan been in that situation and I had not been called when I could have been... I would have thrown a hissy fit the likes of which have never been seen before. Hell hath no fury like a pissed off and wronged Sage. I would have done everything I could have done to own someone and changed some serious policies. __________________ If only closed minds came with closed mouths. Minds are like parachutes, they function best when open. It`s Easier to Change a Condom Than a Diaper Yes, the rumors are true... I actually AM a Witch.

02-26-2007, 06:40 PM	#19 (permalink)
Gilda 32 flavors and then some Location: Out on a wire.	First, the crushed victim who will live just long enough to say goodbye to a loved one is an old urban legend. In addition to Signs and Homocide, it shows up in an episode of 3rd Watch (car accident combined with a bridge collapse) and at least one other show I can't place right now, with a man crushed between a delivery truck and a loading dock. I'm not saying that's what this is, and it certainly doesn't hurt to accept the story as true for the sake of discussion, so assuming that it is . . . I ask myself what I would have wanted had I been conscious and about to die at the bottom of that ditch. I'd want the chance to say goodbye to Grace and Sissy. Not to have them there to see it, but to talk to her and say goodbye. As it was, Sissy was there most of the first day and both of them the day following when I was still in a coma. I ran it by Grace, a former EMT, and her response was, paraphrased: "The job is to treat the patient, get him stable for transport if further treatment is required, and get him to the nearest appropriate treatment facility as soon as possible. Having a spouse there during critical treatment usually causes problems rather than helping in most situations. I've never been in that specific situation, so I have no way of knowing exactly what I'd have done, but contacting family is generally the the job of the police, hospital, or dispatch. I might have given him a chance to say goodbye, but waiting for the wife to get there so she could see her husband die a violent and messy death? Nope." __________________ I'm against ending blackness. I believe that everyone has a right to be black, it's a choice, and I support that. ~Steven Colbert Last edited by Gilda; 02-26-2007 at 09:06 PM..

02-27-2007, 04:32 AM	#21 (permalink)
Gilda 32 flavors and then some Location: Out on a wire.	Thank you for the update. It's good to hear that she wasn't penalized much for her acts of kindness. __________________ I'm against ending blackness. I believe that everyone has a right to be black, it's a choice, and I support that. ~Steven Colbert

02-27-2007, 02:03 PM	#22 (permalink)
jorgelito All important elusive independent swing voter... Location: People's Republic of KKKalifornia	Gilda, thanks for giving us Grace's opinion on the matter to help supplement Analog's professional opinion. It helps to bring a little balance to this emotional discussion. I don't think any of us can truly appreciate the EMT's side of things nor the victim and victim's family's side of things without firsthand experience. For those so adamant about one last farewell, that may not even be possible given the conditions described. Plus the gruesome acts surrounding the deaths may not be the best scene for the families involved. I'm not so sure I would want my family to see me convulsing, vomiting, bleeding, and defecating all over myself nor would I want to see another go through the same thing. I'm sure it's not so nice and neat like in the movies. But then again, maybe I would. The finality of it all makes it a tough decision.

02-27-2007, 10:10 PM	#23 (permalink)
ngdawg peekaboo Location: on the back, bitch	Another thought to this occurs to me that, when a paramedic assesses a situation and the patient is coherent, how much of the patient's wishes is he/she supposed to consider? If there's a DNR (and many times it can't be found when needed, as in the case of my great-aunt, who was put on life-support after a fall because no one could locate her DNR instructions), then I would presume that paramedics would stop life-saving or life-prolonging stratagies. But what if the patient says 'no drugs', even if those drugs helped save his/her life? Then we come to something like this, where he wanted to not be given them until they got hold of his wife. For those who are or were EMT's-would you then be obligated to make that contact if it was determined that nothing would progress until it's done? Another question-is it normal for EMT's to visit with their patient or family afterwards? When I was taken by paramedics to the hospital, they later stopped by to see how I was faring, which I thought was a nice gesture. __________________ Don't blame me. I didn't vote for either of'em.

02-28-2007, 02:05 AM	#25 (permalink)
little_tippler Leaning against the -Sun- Super Moderator Location: on the other side	Every situation is different. I don't think she did anything wrong, especially if in the end the wife was grateful. It may not be part of her job, but if in this situation it did no harm, then I don't see why se can't be human. I see the point made by Analog and I think for some cases, it's perhaps not the right thing to do. It's not part of the job. But every case will call for different decisions. __________________ Whether we write or speak or do but look We are ever unapparent. What we are Cannot be transfused into word or book. Our soul from us is infinitely far. However much we give our thoughts the will To be our soul and gesture it abroad, Our hearts are incommunicable still. In what we show ourselves we are ignored. The abyss from soul to soul cannot be bridged By any skill of thought or trick of seeming. Unto our very selves we are abridged When we would utter to our thought our being. We are our dreams of ourselves, souls by gleams, And each to each other dreams of others' dreams. Fernando Pessoa, 1918

03-01-2007, 08:37 AM	#27 (permalink)
Demeter Psycho	My brother tried to resuscitate my Dad as he was passing, and it haunts him to this day that he saw my Dad in that position, and his failure to prevent the inevitable. The experience left him broken and guilt-ridden. That sticks in my mind as a reason to not be there. I did have the chance to say goodbye to a loved ones twice, shortly before they passed, but wasn't present at the exact moment of death. I think I prefer it that way. I don't think I'm strong enough to 'share' someone's death...if that makes any sense. __________________ I am not bound to please thee with my answers. William Shakespeare

03-02-2007, 10:00 AM	#30 (permalink)
ngdawg peekaboo Location: on the back, bitch	When my father-in-law died, he and the MiL were on vacation in Florida. He had dropped over-my mother-in-law heard a thud, came running to where he had been sitting, knew what'd happened and began pounding on his chest while calling the front desk. They had no defribillator hand, no one on staff knew CPR; they called for an ambulance. Because she'd been pounding on him, the EMT's were obligated to 'continue' resuscitation efforts. Because the EMT's had continued resuscitation efforts, the ER was obliged to do so....all 'protocol'. The man was dead before he hit the floor. Mom had be been pounding on him, screaming at him not to die on her-but to the EMT's, it was 'resuscitation'. As lay-people, we're in a damned-if-you-do, damned-if-you-don't position. If you run to help, whether you know CPR or not, you could be held liable for any failures. If you stand by and do nothing, you could be held under 'good samaritan' laws or feel guilt for not being able to assist. And, if it's a loved one and you go into panic mode, it starts a chain reaction like above. __________________ Don't blame me. I didn't vote for either of'em.