Last night I worked out of a different station to normal, although it was still in the same complex of stations, with a team leader assessing my clinical skills. It was an interesting night, and although I was going to nothing except the most serious 'Category A' calls – I still ended up getting called to a drunk.
I had two 'suspended' patients, one of which had been dead some time, and had been found by his relatives deceased in bed. There was nothing we could do for the patient, so the other crew on scene were left to arrange the police to deal with the death.
The second suspended was rather more interesting, in the 'Chinese Curse' fashion.
The call was given as a 90 year old female with difficulty in breathing, and on reaching the scene we were directed into a room with around 15-20 people who were wailing and praying over a very sick old lady.
At first, there was no way I could reach the patient, so I ordered the people out of the room. Some left, although they were quick to return, and I quickly looked at the woman – she was breathing, but her breathing was very poorly. I prepared our equipment to give her oxygen but as I did this, I looked up and saw that she had stopped breathing. A quick pulse check showed that her heart had stopped as well. At this point a lot more of the family came back into the very small room and started to, well, get in the way.
We started CPR, and a second crew turned up. The family were very unhappy that we were attempting to resuscitate their elderly relative, and while I could fully understand this, for resuscitation, is not a pleasant thing for anyone to go through, there was little we could do. If we hadn't attempted to resuscitate her, then we could lose our jobs and, perhaps more importantly, rob this woman of any chance of survival.
So we continued to resuscitate her, and prepared to remove her to hospital – at which point the family became really upset, and adamant that we should leave her alone. It got so bad at one point that my crewmate called for police backup.
There were a lot of angry looks directed to us, and various mumblings that we didn't understand their culture and religion. I can understand this, but still, our hands are tied. If someone suspends in front of you, and they don't have a 'Do Not Resuscitate' order, then we have to attempt a full resuscitation. To do anything else would be to allow someone to die, and therefore a dereliction of our duty of care.
We decided to meet the relatives halfway, in that we would follow our resuscitation protocol, which allows us to cease resuscitation if there is no response after 30 minutes of CPR and drug therapy. This way, the relatives wouldn't have us take the patient to hospital for a (most likely) meaningless attempt at treatment. They seemed somewhat happier that we were doing this, and calmed down a lot.
We treated the patient for 30 minutes and there was no recovery, she was recognised as deceased, and we left the police to deal with the paperwork that follows after someone dies. I think that we handled the situation as sensitively as possible. There is always a worry that what we consider best for a patient, might not be what the family consider in that patient's best interests – but in some circumstances our hands are tied by procedure and protocol.
While I think we did the best we could for everyone concerned, I wouldn't be surprised if a letter of complaint found it's way to the LAS.
But as we weren't nasty to the family, and followed our protocol – I should think we will be alright.