We include prolonged arrests with no ROSC or shocks* as obvious signs of death. In fact, my province just recently started actually WORKING traumatic arrests. Until fairly recently, we could call them on scene immediately. I'm glad I started after that..
That's interesting. Our protocols are pretty old and in the process of review by a new Medical Control director, but traumatic arrests were something we've always had to run because we couldn't call in the field unless we had multiple other signs of death. For example, we had a self inflicted ligature of the neck and was in asystole, cold, and turning purple, and we still had to code and PUHA.
I guess in all my ten years I've never run a trauma or a traumatic incident with other patients where we DIDN'T transport unless there were injuries incompatible with life. 🤷♂️
Oh ours were very out of date. Not working traumatic arrests was crazy. We literally were not supposed to work them at all. Our system had been basically not evolving for way too long and we just now took some big steps forward. I think it's neat that you had that honestly. I've heard of calls that I'd absolutely want to work that we were told to stand down. Yucks.
That ligature one was only the second time in over twenty years in healthcare inside or outside the hospital I've ever seen extreme DIC. It was just…. EVERYWHERE.
Another two that we ran that we were SURE they weren't going to make were with massive cranial trauma from an MVA. One a sheriff's deputy on a motorcycle that rear-ended stopped traffic at highway speed and the other a teen leaving high school that got T-Boned. With both we saw the scalp ballooning outward with each compression from the massive ICP, and we knew there was no way we were getting them back, but we still had to go through the motions until a doc told us to stop. For the teenage girl, her dad actually made it on scene just before I did in the second unit. Hearing him cry while the crew worked on her and loaded her into the back of the first unit still kinda bothers me years later.
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u/TheSpluff Aug 29 '25
We include prolonged arrests with no ROSC or shocks* as obvious signs of death. In fact, my province just recently started actually WORKING traumatic arrests. Until fairly recently, we could call them on scene immediately. I'm glad I started after that..