On the third Day of Christmas Happy Medic gave to me…

3 Triple Os

EMS 2.0

and a British Medic dressed in green
Some call them Triple Os, others DOA, DNR, 802, there are a wide variety of codes for us to convey the somewhat insensitive radio traffic of “This guy is pretty dead over here.”

But, they travel in threes don’t they?

And not just celebrities, but regular folks as well.

How many different ways can we describe death?

They have passed on,

no longer with us,

in a better place,

with God,

looking down on us,

When a patient of mine is pronounced dead it is in one of two scenarios.  Either I have worked on them or have not initiated treatment.  When I have not initiated treatment it is because I have witnessed certain conditions that are not conducive to life.  Rarely will I use these categories on scene with the family, it is not needed to remind a mother her son is dead because I can see his brain or because his heart rhythm no longer pumps blood because of all the bullet wounds, but harder to explain is the seemingly extensive treatments we complete on scene, only to suddenly stop.

A great deal of hope comes in the door when you do in these situations.  Her husband was lifeless and she called for help.  Minutes later you arrived and began pumping on his chest, breathing for him and giving him medicine, just like on her favorite medical show on TV.

Just when she was getting the situation under control, just as she had a glimmer of hope that he may not be as bad off as she thought…

…you stop.

Everything stops and suddenly the person pumping on his chest is standing and sighing.  The person giving the medicines is counting the pile of empty boxes and making notes.  You take off your gloves and turn to her and she knows exactly what you are about to say.  But she won’t hear you.  She wants to cling to that hope for as long as she can, it’s all she has.

As you approach and take a deep breath, what you say in this moment could be the beginning of her healing or the spark that ignites her grief.

Be honest, use clear terms.  Don’t apologize, it opens the thought that something else could have been done.  Lead them to the other room while your crew cleans up as best they can.  Sit with her, don’t look down at her and tell her what happened.

“His heart stopped and we were unable to get it started again. He is dead.  My co-workers are removing the mess we made and if you like you can go back in in a few moments, but first, is there someone I can call? A neighbor, family or clergy?”  Often that third will earn you a quick look as if you knew something secret.

When your crew has finished, ask her if she would like to go in and be with him/see him/talk to him and be there when she does.  Answer all her questions while you complete your report and await the ME or PD, just to make sure she doesn’t pull the tube or the line.

Be respectful, be honest, and get ready for the next 2 times you’ll have to do it.

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