Recently, a county EMS agency was taken to task by local media when a crew left the body of a deceased individual outside in public view after an unsuccessful resuscitation. According to local news accounts, it took nearly three hours for a funeral home to retrieve the body. The patient’s wife was sitting with the body for much of that time.
Not having spoken to anyone directly involved with the incident, I find some of the reported aspects a bit vague. However, a couple of key points did come to mind as I read about the incident, mostly centered on communication and public relations.
Field pronouncements and patient transport
With a growing number of EMS systems discontinuing the futile practice of transporting cardiac arrests, field pronouncements have become the norm. Unfortunately, EMS providers are often inadequately trained on how to manage a death scene, from delivering bad news to surviving family, to how to best manage the body.
Most EMS systems have some type of determination of death protocol in place, and many provide some guidance on how to preserve the body for investigation or removal. Fewer systems have guidelines in place that speak to the issue of leaving a body in public view. Does your EMS system have such protocols or guidelines? Respond to this EMS1 Poll.
It makes sense that if there were suspicious circumstances surrounding the death, that the body and scene would be preserved as best as possible for a medical examiner investigation. But in the majority of cases, it’s likely that the death occurred through natural means and the medical examiner may not respond to such scenes.
Policies and procedures are generally in place to address these situations, such as assisting family with arranging transportation or requesting a funeral home to retrieve the body.
However, in a situation where there is no immediate family on scene and the body is in a public space, there should be guidelines for the EMS provider to follow, as to protect the dignity of the deceased. This may mean removing the body to a more private location, including a medical facility in more extreme cases. Alternatively, being careful to cover the body fully, or even to provide some form of a shroud or visual barrier could afford a sense of privacy.
It’s difficult to have an EMS crew remain on scene after the resuscitation phase has concluded. Most systems can’t afford to keep their units out of service as calls for service continue to come in. It appears that an appropriate handoff between EMS and law enforcement did occur in this case. It also makes sense that a consistent set of guidelines should be in place that ensures the myriad of details that must be completed by EMS prior to departing the scene.
EMS public relations
Subsequent local media reports indicated that there were some communications between the EMS agency and the family of the deceased, although no details were provided. However, I suspect that the family felt that they had not received a satisfactory explanation, which prompted them to go public with their side of the story a month after the incident. Certainly, the reports suggested that the agency was not responsive to initial contacts.
Explaining these situations to upset family is difficult, no doubt. What’s worse is not responding at all. While it’s true that it may take some time to respond back immediately, due to investigation and compiling of the facts, it’s critical to keep communication lines open. It can be as simple as acknowledging someone’s complaint, with a promise to follow up as soon as it’s appropriate to do so.
Having to play defense in the media is not a pleasant position for an agency to be in. While there may be a plan in place to prevent this type of situation from happening again, in this case, the damage is done. There’s likely some bridge building to be done between the community and the EMS agency in the future.
