Question about ambulances?

[Bookist]

Have got 'Ambulance' on in the background right now. It's clear how strained and under pressure the ambulance service is.

The senior paramedic is en route to a call of an elderly man, found not breathing and cold in a care home. But before he arrives he's told the elderly man is definitely dead.

So, why does he continue on to the care home anyway and then has a chat with the care home owner about the deceased man's habits, and also what will happen now he's dead (it's a care home so surely this can't be a new experience for them?).

As soon as the paramedic was informed the man was already dead why wouldn't he be immediately diverted to another emergency? Does anyone know?

I think he has to go to declare them dead, not sure a care home worker is allowed to declare a person deceased no matter how obvious. I remember as a student midwife watching the nurses do cpr on someone on a ward with rigor mortis, they had to until the doctor came and said the person was dead.

the stuff about what he liked to do I thought was for tv/the cameras. 🤷‍♀️. Maybe I’m being cynical and he was trying to be nice to her as she was upset.

Thank you. I thought only a doctor could declare someone dead? Didn't realise a paramedic also could.

Still don't get why he went on to spend time chatting with the care home owner though? Yes, perhaps 'nice' for the owner, but not remotely nice for the dozens of other emergencies who are waiting hours in pain etc.

When my mil died from advanced dementia, not only did they send an ambulance out when my fil called, but they also sent him out to fetch a defib.

One of the most stupid things I've heard really. It could have ended up with more deaths, as he admitted he didn't even think about the speed limit and I doubt was driving safely. Really cross with them for that.

Cross?! How is the caller handler magically meant to know all the facts and see the scene? They follow a protocol until someone who is trained is on scene and can make a clinical judgement. People do really silly ignorant things and say all kinds of things that don't mean what they think they mean. To allow for that, the handler follows a standardised procedure. Why did your FIL speed or go for a defib or even call an ambulance for that matter. A doctor or nurse with appropriate training could have made the declaration rather than using a 999 paramedic.

Yes, it’s to officially diagnose the death and where appropriate discuss with the coroner’s office (or police) where the deceased person’s body goes (eg. released to the family/goes to the care of the coroner).

The chat with the staff may be a) to find out what happened/if there’s anything that’d influence the above, b) to support them if it’s been traumatic.

But surely it's not the paramedic's role to provide emotional support for the care home staff? Especially when there are clearly dozens of other people, severely injured or in pain, who are waiting hours for a paramedic.

Shouldn't paramedics only be deployed to treat emergencies? Not touchy feely aftercare in decidedly non emergency settings?

I'm not sure the programme is 100% true to life. I'm sure someone said on another thread last series that the follow up calls between the call handlers and the paramedics to ask about the patients never happen in real life either

It's to formally verify the death. A trained medical professional can confirm death, this includes nurses if the patient was expected to die (usually palliative and hospice). A doctor completes the medical certificate but is not necessarily needed for confirmation of death.

Because the care home owner is now a patient in their own right if they've come across a dead person

Paramedics attended to declare my family member deceased. There was no doctor available. They don’t do it for the shits and giggles that’s for sure.

Wtf. They go to verify someone is dead and then comfort the person they confirm that too. They don't go specifically to comfort someone

Not sure if you’ve ever found a body/ tried to resuscitate someone - just every so often, even when it’s your job, it flipping nearly breaks you - contrary to MN opinion, not everyone in healthcare is completely heartless!

It’s to verify the death.
Im a community nurse and I verify the expected deaths of my patients. A death which has been discussed, planned, has the appropriate paperwork. Paramedics can do the same.
Sometimes a care home will call 999 at family request or in a panic over the resident. They want help, help now, despite the patient having died. It’s an appropriate response for the handler to send a paramedic.

@PoodlesRUs
I would have thought that sending a bereaved spouse out in a car to fetch a defib shouldn't be done at all. They will not be driving safely. My fil was definitely not thinking straight; he's normally a careful and slow driver. I very much doubt if someone had stepped out in front of him he'd have even noticed them.

I was witness to an accident where a gentleman was rushing to see his wife at the hospital having been told it was last few hours.
He hadn't a clue what was in front of him, he even tried to drive off after he'd hit two cars and a road sign. The police said it wasn't the first accident they'd attended in similar circumstances.

He arrived back at the same time or after the ambulance, but my mil was non-verbal, non-mobile and we think in quite a bit of pain. He'd told them she had advanced dementia.
Even if it had been possible to resuscitate her, it would have been a really bad thing to do. She'd have had another hospital stay (where she always got very distressed) at best, and she would not have lasted another month, her death was very much expected.

Amen to that.

What do you mean 'release to the family'? I'm guessing the family can't just keep the body.

@Kendodd release to the family as in for them
to arrange on going care with a funeral director rather than the police arrange it via coroner if needed for unexpected death or injury or expected death through things like mesothelioma or suicide.

if there are no concerns about the death then the family (or perhaps in this case the care home?) then pick their preferred funeral director to take care of the body rather than going to the coroner’s choice/police.

So say an elderly relative dies, med bod comes along, confirms they're dead, leaves, then you have to phone round funeral homes to collect the body?

I see what you are saying re driving when stressed and I wonder if I've misread you a little. But your FIL's panic does add to my point that the public, as well meaning and as emotional as they are, cannot be relied on to give sound accurate information. That's why call handlers rely on protocols such as send for a paramedic, instruct people to reach a defib if possible. I'm unclear if when you say MIL was non-verbal etc whether you mean this is how she was generally and then arrested and 999 call/defib/amb followed or if you mean she was non-verbal when amb arrived? Because again that would mean there was confusion somewhere as she hadn't arrested and didn't need a defib (I do think we may have crossed wires there though).

Your point re resus is very valid and shows why DNARs, TEPs, Advanced Directives and Respect plans are so essential in all our lives.

Finally, I would add that all staff I have ever seen make EoL calls to families absolutely stress that people should drive safely or ask if someone can bring them in. However, I'm sure we can both acknowledge that a number of distressed people will disregard such advice and take risks. It's an imperfect world!

Yup. (If you’ve got no clue where to start they’ve usually got a list of local ones to help as a starting point).

And do they offer a 24 hour service to collect the body?
I had no idea this is what you have to do. I always imagined an abulence would come and sort of, take over. Take the body away and put it in the hospital fridge while you sort yourself out and find out what youre supposed to do next.

Suppose it's your husband and they die in the bed you share! I can't believe your just left with them.

Yep. The funeral home will collect the body normally

You ring a funeral directors. They can't always come right away. Sometimes it can be a few hours.