We have been following a tragic case involving the death of a skier at the Sugarloaf Ski area. The victim’s widow claims she was left by the side of the road by the transporting ambulance as it was enroute to the hospital, and that the ambulance subsequently discontinued treating the victim and returned his body to the ski area.
David Morse of Nova Scotia died on January 12, 2012 after striking a tree and the incident remains under investigation by both the hospital based ambulance company, Northstar Ambulance, and the Carabassett Valley Police Department. The resulting media coverage has garnered near universal public condemnation of the medics from all corners of the country and Canada.
On December 1, 2011, Maine EMS, a division of the Maine Department of Public Safety, issued new EMS protocols that specifically allow personnel to discontinue CPR and ALS activities following 20 minutes of unsuccessful resuscitation efforts.
Those protocols read as follows:
TERMINATION OF RESUSCITATION
Resuscitation should be terminated under the following circumstances….
2. When the patient is in asystole for greater than 20 minutes OR unresponsive to advanced cardiac life support with a non‐shockable rhythm after 20 minutes of resuscitation.
3. In the absence of ALS, when the same Maine EMS licensed crewmember has documented the absence of all vital signs for 20 minutes, in spite of BLS, except in the case of hypothermia….
2. IF DEATH OCCURS EN ROUTE TO THE HOSPITAL, the body need not be returned to the scene but can be brought to the hospital or other suitable storage place as determined by distances and needs of other patients in the ambulance. If the body is left anywhere other than the hospital or designated temporary morgue, the body should be tagged and the Office of Chief Medical Examiner should be advised.
It would therefore appear that if the widow’s allegations about Northstar’s stopping treatment are in fact true, they may have been permitted by Maine EMS Protocols. Left unexplained is the decision to leave Morse’s widow standing by the side of the road.
Here is a copy of the protocols. 2011MaineEMSProtocols
I would be interested to hear from readers about their state’s protocols for the termination of resuscitation. The traditional rule (old-school) was that resuscitation could only be discontinued when rescuers are physically exhausted, when equally or more highly trained health care personal take over, or when the patient regains pulse and respiration.
Over the years additional exceptions have been added (DNR, medical control, etc.) and as we have discussed here, society continues to struggle when it comes to making these kinds of decisions. It would seem that Maine’s new protocols go about as far as I have seen protocols go in allowing crews to stop resuscitation efforts.
Good idea, bad idea… what do you think? At a minimum by reviewing the protocols we can better understand what the Maine medics may have been thinking on January 12, 2012… (whether you agree with the protocols or not).