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! 

The BLS PCS lists discusses this within the Deceased Patient Standard, Obviously dead criteria  which includes, “2. Absence of vital signs and c. gross rigor mortis (ie. Limbs and or body stiff, posturing of limbs and or body)  

If you do not believe that the patient met the criteria for obviously dead, it is always reasonable to initiate resuscitation. For the in-hospital practitioner, they may use different criteria to decide whether or not to continue resuscitation and their lack of familiarity with the BLS PCS may give rise to the questions they have as to why paramedics may start resuscitation in the prehospital environment.  

BLS,Cardiac/Circulation,Trauma Cardiac Arrest,Trauma Patient

BLS-PCS, Deceased Patient Standard, Obviously dead, Penetrating Trauma, Rigor Mortis

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