Scenario: 91 yo M pt VSA, last seen 7 hours ago, extensive medical hx, rigid in his jaw, mouth shut, no lividity, incontinent of urine, coffee ground emesis to his upper shirt, pale, cold to touch and hx of pacemaker. In and out of hospital multiple times recently. General decline recently. Would you be at fault to fit this pt in the deceased pt standard since there is only rigidity to his jaw? Does rigidity have to be gross for a pt to fit the deceased standard? Does hx and last seen baseline alter the deceased pt standard?

Hello, I was hoping you can put my overthinking mind at ease. I responded to a traumatic vsa. Single stab wound to the chest with the knife still impaled. Single stab wound to the lower left side of his chest(left of his nipple). He was asystole, very rigored at the jaw but no other obvious signs of “ Obivously Dead Criteria” My question is technically can we deem that enough to not continue resuscitative efforts? Or do they need gross rigor mortis at the extremities or lividity to call it? We decided to run the call as we did not feel comfortable calling it with just rigor at the jaw. Removed the knife as it was impending CPR, applied an asherman seal, rhythm analysis revealing asystole, double NPA with two handed seal and adequate ventilations with equal chest rise and fall with good air entry(did not needle decompress), end tidal of 20-22, IO access and transported. Arrival at the ER, got odd looks from ER team and got questioned why we transported someone who was rigored at the jaw and explained to them that we did not have enough to pronounce them on scene. Hoping you can give some clarification on this challenging scenario and whether I could’ve done that call differently. Thank you!