New Protocol Lets Washington EMTs Forgo Resuscitation — Emergency Medical Services (EMSResponder.com)

New Protocol Lets Washington EMTs Forgo Resuscitation — Emergency Medical Services (EMSResponder.com):

New Protocol Lets Washington EMTs Forgo Resuscitation

CAROL M. OSTROM
The Seattle Times

"Compelling Reasons" | A new emergency-response protocol is designed to spare families the nightmare of an "inappropriate" resuscitation.

Mary Sundborg was a spirited woman of 100 who had long endured advanced colon cancer and two strokes. And she knew how she wanted to die: at home, peacefully, with dignity.

So with the help of her eldest son, she signed an official order specifically directing emergency responders not to attempt CPR.

Then came Jan. 3, the day Sundborg stopped breathing. Her nurse, who wasn't sure at first what was happening, called 911. When emergency medical technicians (EMTs) from the Fire Department arrived at her Magnolia home, they pulled her out of bed, attached their equipment and began pushing on her chest.

"Put her back in bed!" the nurse yelled. Sundborg didn't want to be resuscitated, she told them, waving the "No-CPR" order. One of the emergency workers told her the order had expired, and kept going.

But Sundborg was dead.

"It was terrible, absolutely terrible," said her nurse, Bonnie England. "It felt very disrespectful. It was just so wrong."

And it was far from an isolated case. Emergency medical responders, long trained that a 911 call is a request for resuscitation, have routinely ignored family members who ask that CPR not be given to their loved ones who are dying of terminal illnesses.

This year, that is changing in most King County jurisdictions, thanks largely to years of effort by two South King County paramedics who saw the current system as an affront to patients' wishes for peaceful death.

For the first time, EMTs the first responders to 911 calls are being given the latitude to forgo resuscitation when they judge it to be "futile, inappropriate and inhumane" even when there is no official paperwork.

I have been on calls where this little bit of latitude in our EMS protocols would have prevented us from going through the motions in a futile attempt at resuscitation on a patient that you just knew was not viable. I mean a patient who had just passed on around the time of the 911 call, not someone who had been dead for hours or days. This is especially bad when the family is on scene and does not want you to resuscitatee the patient.

This is the way the system is set up, if we do not follow the protocol and something goes wrong it is our fault. There is not much wiggle room written in the protocols. Maybe Virginia EMTs can look forward to this protocol change.