New policy allows more to die at home

When we learned of a new statewide policy allowing EMTs to leave dead people in their homes it sounded callous, like a dump-and-run scheme designed to benefit ambulance companies.

But after some research and talking to state officials, we understand it as a justifiable response to changing times and technology. But it may take some time for that understanding to spread.

Some older readers may remember when funeral directors were the ambulance drivers for many rural areas. Some funeral hearses were even built to serve double duty with interiors that could be switched out depending upon the type of run.

In urban areas, firefighters trained in first aid were responsible for moving people from an emergency or illness at home to the hospital.

The premium then was placed on packing up a sick or injured person and rushing them — with lights flashing and sirens wailing — to the closest hospital.

As a result, many of us still have the expectation that when an ambulance arrives, the first priority should be loading up and moving out as quickly as possible.

Over the decades we learned how the first 10 or 20 minutes in a medical emergency can be the most critical.

We have responded by greatly expanding the training to the EMT level and vastly increasing the technology carried by crews to quickly assess and stabilize a sick or injured person.

EMTs now spend more time in the home working to save a life rather than rushing patients away to care that might be too late in coming.

But a recent change in practice has raised some eyebrows in Maine.

In December, Maine updated its EMS Prehospital Treatment Protocols giving EMTs and paramedics the authority to stop resuscitation efforts after 20 fruitless minutes.

Before, first responders would contact a medical control, like an ER doctor, to make that call.

When patients are treated on the scene, more of them are going to die on the scene rather than in the back of a speeding ambulance.

And that has been an adjustment for families and ambulance crews.

Now, many families will learn in their own living room that their loved one has died . . . and an EMT will likely tell them.

After that, the rescue crew may pack up and leave while the family waits for a funeral home vehicle to arrive. And that may create, well, an awkward moment.

Yet family members have been dying at home since the beginning of time. When you think about it, the last wish of many older people is to die at home rather than in a hospital.

Those who have attended a family death can probably attest that it is painful and vivid, but also a loving moment when everyone realizes a circle has been closed.

The new policy may allow for more of those quiet moments.

rrhoades@sunjournal.com

The opinions expressed in this column reflect the views of the ownership and the editorial board.

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Comments

Bickford Wiles's picture

Death Panels

Its only just begun.There are far more implications from this Policy.I want comment due to the nature of the subject.

Sharon Dudley's picture

I'd die at home any day

I have personally had a person in my life die at home just recently. The EMT/Paramedicss were phenomenal. Have you ever witnessed a resuscitation? To stop resuscitation is not taken lightly. It is physically and emotionally draining whether you know the patient or not.

The loss we had was unexpected and over whelming, but clearly they did all that they could.

The news was handled delicately and professionally and my loved one passed with dignity. We were allowed to begin the grieving process at home in private. I was not creeped out by the body being in the kitchen while we waited for the funeral home. Why? Because death is a natural process. We're all going to go one day. I think it all depends on how comfortable you are with mortality.
I, personally, would rather go at home than in a hospital attached to all kinds of wires.

No, an EMTs/Paramedics are doctors, but they CAN perform the same life saving techniques.

Any thoughts of the quality of life if anyone was resuscitated after 30 minutes or more? Not good. In our case, CPR was performed for 30 minutes before the ambulance arrived and for 30 minutes after.

We don't give our EMS crews enough credit. EMS and Doctors are not GODS.

Bickford Wiles's picture

Dying without Dignity

It sounds like this author is prepared for the ACA.No more wasting money on a lost cause.If you beleive that all EMT's are doctor quality,you are dreaming.And for the "waste of time" ? Please ! Totally frightening.

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