What is an 'Obvious Death'?​

• As per the BLS PCS Deceased Patient Standard, an obvious death is defined as gross signs of death that are obvious, including by reason of:​
  • Decapitation, transection, visible decomposition, putrefaction; or ​
  • Absence of vital signs and:​
    • A grossly charred body;​
    • An open head or torso wound with gross outpouring of cranial or visceral contents;​
    • Gross rigor mortis (i.e. limbs and/or body stiff, posturing of limbs or body); or​
    • Dependent lividity (i.e. fixed, non-blanching purple or black discoloration of skin in dependent area of body).

What if there is stiffness in the jaw but no other 'obvious death' criteria?

• As per the Deceased Patient Care Standard, gross rigor mortis is defined as limbs and/or body stiffness. Other causes of jaw stiffness could be:​
  • Trismus​
  • Trauma​
  • Certain medications (usually antipsychotics)​
  • Tetanus​

Jaw stiffness alone is not an indication of rigor mortis. If isolated stiffness of the jaw is present, paramedics should continue resuscitating the patient as per the appropriate medical directive.

Do I need to contact a BHP if the patient meets 'obviously dead' criteria?​

• If the patient meets obviously dead criteria, you do not need to contact the BHP to obtain a TOR. Follow the procedures outlined in the Deceased Patient Standard.​
• If there is any confusion or uncertainty as to whether the patient meets obviously dead criteria, contact the BHP for direction.

What should be documented on the ACR when patient meets obviously dead criteria?​

• Documentation should "paint" a clear picture for the auditor. ​
• Remember to include the assessments that lead you to determine how the patient met obviously dead criteria (e.g., the patient was grossly charred or had dependent lividity throughout the body)​

Points to remember..​.

• Obvious death is irreversible and thus not treated by paramedics. ​
• Jaw rigidity alone is not enough to meet the criteria for 'obviously dead'.​
• In the setting of 'obvious death', paramedics do not need to complete a BHP patch for a TOR. If there is any uncertainty, a BHP can be contacted for direction.​
• When documenting on your ACR, be descriptive and thorough when explaining how/why the patient meets the 'obvious dead' criteria.

No additional resources available for this #SWORBHPTip.