Our department recently offered an early retirement buy-out option. I understand a half-dozen or so people took it. So next month, 6 or so of my colleagues will run their last call and close the door on their career. Six people will write the final chapter and be done.
It makes me wonder. I wonder what that’s like, to hear the tones go off and say, “Yup, this is probably it, the last call of my career.”
What will people say about your EMS career when you’re all done? For many of the readers here at the spot, retirement is a long way away. It’s hard to imagine what is will one day be like to not be in EMS anymore. Yet, it’s worth considering, because you never really know when your last call will be.
Consider Elizabeth Ann Mitchell.
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It is a moment in time that you will certainly face at some point in your EMS career. Most of us will face this decision many times over throughout our tenure. Should I attempt resuscitation?
- Is your patient gone?
The question may be complicated by family, friends or bystanders who have, in good faith, started CPR prior to your arrival and fully anticipate that you will continue. Or perhaps other members of emergency services arrived before you and declared the patient not workable. They may advise you of their findings, without much further detail. “This guys dead.”
Often, responders who aren’t responsible for documenting the obvious death criteria can be much more casual about the determination of death. They may decide not to try to resuscitate because the patient “looks dead.” They aren’t the ones who have to write the paperwork and meticulously document the physical findings that allowed them to make the determination of obvious death … you are.
How will you tell a family member or helpful bystander that it isn’t medically reasonable to continue CPR? How will you advise the well meaning first responder who failed to initiate resuscitation efforts that you’re going to begin them in earnest anyway? To proceed with confidence you need to know your resuscitation guidelines and you need to know your obvious signs of death. You need to know them well.
When you walk into that room and assess the patient there won’t be time to consult reference cards. People are going to want a definitive action plan quickly. protocols will vary from region to region, but I have found this list to be accurate and useful across many states and many organizations. Commit this one to memory.
EMT’s can objectively decide to withhold resuscitation in the presence of:
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