Prehospital Death Determination

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PREHOSPITAL DEATH DETERMINATION For all emergency scenes where patient needs exceed available EMS ALERT resources, initial assessment and treatment shall be in accordance with an approved triage methodology. 1. Patients who appear to have expired will not be resuscitated or transported by Clark County EMS personnel if any of the following obvious signs of death are present: a) Body decomposition b) Decapitation c) Transection of thorax (hemicorpectomy) d) Incineration OR if ALL four (4) presumptive signs of death AND AT LEAST one (1) conclusive sign of death are identified. The four (4) presumptive signs of Conclusive signs of death include: death that MUST be present are: ALERT 1) Unresponsiveness 1) Dependent lividity of any degree 2) Apnea 2) Rigor mortis 3) Pulselessness 3) Massive trauma to the head, neck 4) Fixed dilated pupils or chest with visible organ destruction 2. If there is any question regarding patient viability, to include potential hypothermia, resuscitation will be initiated. 3. Once it has been determined that the patient has expired and resuscitation will not be attempted: a) Immediately notify the appropriate authority; b) DO NOT leave a body unattended. You may be excused once a responsible person (i.e. Coroner’s investigator, police, security, or family member) is present; c) DO NOT remove any property from the body or the scene for any purpose; d) NEVER transport / move a body without permission from the Coroner’s office except for assessment or its protection. If the body is in the public view and cannot be isolated, screened, or blocked from view, and is creating an unsafe ALERT situation with citizens/family, the body can be covered with a clean, STERILE BURN SHEET obtained from the EMS vehicle. REVISED AND ENDORSED BY EMS MEDICAL ADVISORY BOARD 11/03/10 SOUTHERN NEVADA HEALTH DISTRICT .

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Early Post-Mortem Changes and Stages of Decomposition in Exposed Cadavers
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