Policy:
EMS will handle the
disposition of deceased subjects in a timely and consistent manner. State law
states: “…expression of the opinion that death has occurred may be made by a
nurse, an EMT, or any other competent person in the absence of a physician”
(GS 130A-383). If 9-1-1 is called, EMS will perform a medical assessment and
contact the attending North Carolina licensed physician or local medical
examiner as indicated below. Only North Carolina licensed physicians and Medical
Examiners can sign a North Carolina death certificate.
Purpose:
The
purpose of this policy is to:
·
Provide an organized and timely disposition of any deceased
subject.
·
Maintain respect for the deceased and family.
·
Allow EMS to return to service in a timely manner.
Procedure:
1.
For natural deaths,
contact the patient’s private North Carolina licensed physician, describe the
circumstances surrounding the death, and obtain confirmation from the attending
physician that he/she will sign the death certificate. Contact the
patient’s/family’s funeral home of choice for transportation.
2.
For unnatural deaths,
or death without medical attendance (i.e.,
when a person dies and is not under the care of a physician or
when a person dies while visiting from another state.),
contact the on-duty medical examiner, describe the circumstances
surrounding the death, and determine if the medical examiner will give
permission to release the body to a transport service.
·
The following types of deaths must
be reported to a medical examiner:
homicide; suicide; accident; trauma; disaster; violence; unknown, unnatural, or
suspicious circumstances; in police custody, jail, or prison; poisoning or
suspicion of poisoning; public health hazard; deaths during surgery or
anesthesia; sudden, unexpected deaths not reasonably related to known previous
disease; and death without medical attendance.
3.
Do not remove lines or tubes from unsuccessful codes unless
directed below.
4.
Notify the law enforcement agency with jurisdiction.
5.
If subject was found deceased by EMS, the scene is turned
over to law enforcement.
6.
If EMS has attempted to resuscitate the patient and then
terminated the resuscitative efforts, the EMS personnel should contact the
family physician (medical cases) or medical examiner (traumatic cases or family
physician unavailable) to provide information about the resuscitative efforts.
7.
Transport arrangements should be made by law enforcement in
concert with family wishes. If the deceased subject’s destination is other
than the county morgue, any line(s) or tube(s) placed by EMS should be removed
prior to transport.