Photo Courtesy of www.life-save.org
In fact, now it is no longer acceptable to transport cardiac arrest patients to the hospital (Grudzen, 2006). It is considered unethical for many reasons (AHA, 2000): It ties up a needed bed in an overcrowded ED; it ties up needed members in the ED who must continue the resuscitation; it incurs unnecessary hospital charges; it increases time that EMS crews are not available for another call; it gives the family a false sense of hope and causes them much inconvenience in coming to a crowded ER out of touch with their loved one. It can also be dangerous for the family driving to the hospital in a stressed state of mind (Dick, 2007), and most importantly, dangerous to the public and EMS crew travelling to a hospital lights and sirens with attendants providing resuscitation efforts in the back, unrestrained.
Courtesy of gayaruangkepelbagaim.wordpress.com
Photo courtesy of www.finda.com. This photo is the Australian ambulance crew after they pronounced the drowning victim after an hour of resuscitation efforts at Cabarita beach.
Despite the absolute negative outcomes of SIDS patients, there is debate on whether resuscitation should be started on them or not. Most EMS experts agree now it should be withheld (Dick, 2007, Smith, et al, 2005). Regardless, the police need notified and an autopsy needs done, because though Paramedics can easily identify SIDS cases, they show lack of ability to identify child abuse cases (Graham, Olson, Sapien, Tanberg, Sklar, 1997). In most cases involving a pediatric death, whether DOA or TOR, strong grief support needs to be provided to the family, and this falls on the shoulders of the EMS providers.
American Heart Association (AHA), (1995), 1995 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, Ethical Issues, Circulation.
Hall WL 2nd, Myers JH, Pepe PE, Larkin GL, Sirbaugh PE, Persse DE., The perspective of paramedics about on-scene termination of resuscitation efforts for pediatric patients, Resuscitation. 2004 Feb;60(2):175-87
Morrison LJ, Visentin LM, Vermeulen M, Kiss A, Theriault R, Eby D, Sherbino J, Verbeek R., Inter-rater reliability and comfort in the application of a basic life support termination of resuscitation clinical prediction rule for out of hospital cardiac arrest, ResuscitationVolume 74, Issue 1, July 2007, Pages 150-157