DEAD ON SCENE (DOS)

Originated 1-25-2010

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DEAD ON SCENE (DOS)

DESIGNATION OF CONDITION

The patient will be unconscious, unresponsive, pulseless, and apneic. Resuscitation efforts may be withheld if any of the following criteria are met: obvious injuries incompatible with life; presence of rigormortis or livormortis (lividity); decapitation or visible brain contents; decomposition; neonatal maceration (degeneration of tissue); and/or extensive full thickness burns. Advanced resuscitation efforts may be withheld in the presence of an approved DNR form (Refer to DNR page). Advanced resuscitation efforts may be withheld in an expected death of a terminal patient without a DNR form, but will require Medical Control contact.

EMPHASIS ON PATIENT CARE

EMS personnel should attempt resuscitation on a patient unless there is clear evidence of
unsurvivability.

FIRST RESPONDER, BASIC, INTERMEDIATE AND PARAMEDIC PRE-HOSPITAL MANAGEMENT
1. Assess the scene for safety and determine the mechanism of injury, if any.
2. Assess airway, breathing and circulation.
3. Obtain focused H&P - History, physical exam, vital signs, especially a detailed Mechanism of Injury to determine if there are unsurvivable injuries, rigor mortis (stiffening in multiple joints) and/or livormortis (discoloration of skin at the lowest parts of the body).
4. If there is any question about whether resuscitation should be initiated, contact on-line
medical direction.
5. If enroute when an order to cease resuscitation efforts is received, continue transport of
the body to the receiving facility. The use of lights and sirens is no longer therapeutically
necessary.
6. In general, ambulances should not be used to transport dead persons.