remains pulseless and transport is greater than 15 minutes to a Level I trauma center, consider withdrawal of resuscitation efforts. Despite advances in medical care, the survivability rates of Blunt Trauma & Cardiac Arrest: patients suffering cardiac arrest following blunt trauma remains between 0% - 2% for patients arriving at a trauma center with no signs of life (Zwingmann et al, 2012). The incidence of multisystem organ damage is increased in the cases of blunt trauma. Zwingmann et al (2012) also discussed ACSCOT’s recommendations to withhold resuscitation efforts in trauma patients found to be apneic, pulseless and in PEA/asystole, or other signs of life due to the arguably minimal number of salvageable responses in comparison to the extent of required resources. If the provider suspects an airway obstruction or tension pneumothorax, the provider should attempt to place an airway adjunct and perform bilateral needle thoracostomy if in their scope of practice SPECIAL NOTE: If there are scene or patient circumstances in which providers, family, or other stakeholders would benefit from transporting a patient unlikely to survive their illness/injury, the treating EMS team can elect to do so in a safe manner. EMS providers may also call for medical direction if unsure whether or not to withhold/withdraw resuscitative efforts based on scene and/or bystander circumstances. If asked for a time of death, please provide the at which “TIME resuscitation was withheld/withdrawn.” In all instances of withdrawing or withholding resuscitative efforts, EMS providers should contact law enforcement and initiate grief support. An EMS provider must remain with the victim until released to law enforcement. DOCUMENTATION: Documentation of patient assessments and all aspects of care leading to the decision to withdraw/withhold care are vital. The documentation of any response serves as the legal clinical record of a provider’s assessment. This will become part of the patient’s medical record and can be reviewed by lawyers should the need arise (Wolfberg & Wirth, 2005). When completing documentation for a call in which the Dead on Scene Standing Order is used, there are several
remains pulseless and transport is greater than 15 minutes to a Level I trauma center, consider withdrawal of resuscitation efforts. Blunt Trauma & Cardiac Arrest: Despite advances in medical care, the survivability rates of patients suffering cardiac arrest following blunt trauma remains between 0% - 2% for patients arriving at a trauma center with no signs of life (Zwingmann et al, 2012). The incidence of multisystem organ damage is increased in the cases of blunt trauma. Zwingmann et al (2012) also discussed ACSCOT’s recommendations to withhold resuscitation efforts in trauma patients found to be apneic, pulseless and in PEA/asystole, or other signs of life due to the arguably minimal number of salvageable responses in comparison to the extent of required resources. If the provider suspects an airway obstruction or tension pneumothorax, the provider should attempt to place an airway adjunct and perform bilateral needle thoracostomy if in their scope of practice SPECIAL NOTE: If there are scene or patient circumstances in which providers, family, or other stakeholders would benefit from transporting a patient unlikely to survive their illness/injury, the treating EMS team can elect to do so in a safe manner. EMS providers may also call for medical direction if unsure whether or not to withhold/withdraw resuscitative efforts based on scene and/or bystander circumstances. If asked for a time of death, please provide the “TIME at which resuscitation was withheld/withdrawn.” In all instances of withdrawing or withholding resuscitative efforts, EMS providers should contact law enforcement and initiate grief support. An EMS provider must remain with the victim until released to law enforcement. DOCUMENTATION: Documentation of patient assessments and all aspects of care leading to the decision to withdraw/withhold care are vital. The documentation of any response serves as the legal clinical record of a provider’s assessment. This will become part of the patient’s medical record and can be reviewed by lawyers should the need arise (Wolfberg & Wirth, 2005). When completing documentation for a call in which the Dead on Scene Standing Order is used, there are several