Policy 9–Criteria for Death

Under what two circumstances can CPR and ALS treatments be withheld?

If the patient is obviously dead (per specific criteria) or a valid Texas Do Not Resuscitate form is present.

Is a Texas Out-of-Hospital DNR bracelet or necklace as valid as the paper DNR form?

Yes, it is considered as valid as the DNR form and will be honored.

Name physical signs that indicate resuscitation can be withheld.

Burns to the entire body, decapitation, rigor mortis, post-mortem lividity, hemicorporectomy, or an injury incompatible with life.

What head/chest injury findings indicate resuscitation can be withheld?

Penetrating injuries to the chest or head with asystole verified in two leads, open head trauma, or a gunshot wound to the head.

Besides physical death signs, what other situation lets you withhold resuscitation?

If there is no DNR, but the family requests termination of efforts.

Name contraindications to withholding resuscitation (situations where you should still act).

Patient down time is less than 20 minutes, down time cannot be reliably determined, asystole cannot be verified in two leads, hypothermia is present, pregnancy, or any doubt exists.

For a death from a vehicular or industrial accident, what should you do with the body?

Do not move it unless necessary to resuscitate a living person or if it will be destroyed by fire/explosion; cover it if directed by law enforcement; preserve the scene; keep spectators away; notify dispatch and law enforcement.

For a death occurring at home, what should you do?

Do not disturb anything; move to a position of safety if the scene is unstable; notify dispatch as soon as possible.

What must you always do regarding findings at a death scene?

Document all findings and report any unusual or suspicious circumstances to the first arriving officer.