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Paramedic Services | Effective Date: April 30, 2022 |
Topic: Operations Directives | Replaces: April 30, 2019 |
Subject: Management of VSA/Deceased Persons | Policy No. G.3.25. |
To ensure Paramedic Services staff have a sound understanding of operational and Regulatory expectations surrounding the management of vital signs absent and deceased persons.
In a circumstance of sudden, or unexpected cardiac arrest event, Paramedics shall assume life. Until Termination of Resuscitation (ToR) direction has been issued by a Base Hospital Physician. Paramedics shall immediately upon arrival:
Documentation of resuscitative efforts and findings shall be completed on the ePCR, and each paramedic who arrived scene shall complete an Incident Report.
Paramedics shall complete the transportation to the destination hospital once the patient has been loaded onto the stretcher, or extrication has commenced.
Legal Death requires physician pronouncement of death; however, Paramedics will be required to manage Obvious Death. The designation of Obvious Death may take place following completion of a thorough physical assessment and an understanding of the event history. Paramedics may presume death where there are obvious signs of death as set out in Regulation. Where such a designation has been made, Paramedics shall:
Legally or Obviously Dead persons shall not be transported by ambulance except from a public place, or where no body removal service is available. Deceased persons may not be transported at the same time as a living patient, except where death is pronounced while enroute to a hospital. Paramedics shall adhere to the Deceased Patients Standard as set out in the BLS PCS.
Paramedics shall adhere to the Police Notification Standard for Suspected Foul Play, set out in the BLS PCS. Where foul play is suspected, Paramedics shall:
Paramedics shall recognize and honour a Do Not Resuscitate Order, where such an order complies with the current MOH Deceased Patient Standard. Paramedics shall obtain a valid DNR Confirmation Form with Confirmation Number.
In the event of respiratory or cardiorespiratory arrest in the presence of a valid DNR with Confirmation Number, Paramedic will adhere to directions as specified in the Legislation. Where death has been determined by the Paramedic, they will contact either the patient’s Primary Physician, or the Palliative Care Team. Transport will not be initiated.
A valid DNR Order does not preclude interventions necessary to provide comfort, nor does it preclude transport where required (unrelated to DNR).
Patients who have a valid DNR Confirmation Form may be considered suitable for multiple patient transport if the Paramedic assessment and sending facility team believe that death is not imminent.
Paramedics shall include the Confirmation Number, and other relevant findings on the ePCR. Additionally, Paramedics shall complete an Incident Report.
Emergency Health Services Branch, Basic Life Support Patient Care Standards