Thursday, April 02, 2020

It is what it is.

As the federal supplies find their way to the hotspots the governors have to carry out their priorities.

There are difficult decisions for the governors. 

I believe New York State is instituting what is called "Pronouncing the Dead" authority to EMTs. That is not an unusual act for someone less than an MD. Nurses, be they RNs or LPNs, are taught how to pronounce, especially in Hospice in the home.

This would be a new responsibility for EMTs and of course regardless of discipline or certification or license any pronouncement has to be backed by an MD. EMTs are usually patched into an ER and doctors there can ask what the ambulance workers are finding and validate the pronouncement. With that, the person will be brought directly to a morgue.

This is going to sound cold, but, many people have pre-planned funerals and there are morticians that can reply to a death. That means if there is a pronouncement by an EMT on-site with the validation of an MD, the EMTs don't have to transport. They can remove their isolation gear and clean their hands in the ambulance (which is still clean) and go on to the next emergency. A mortician can be notified by the family and/or the hospital of the death and pronouncement and to pick up the person. 

If morticians are brought in to transport the dead, there is usually an understanding as to the diagnosis of that person established by an MD in Hospice. In this instance, there is a stark difference in a COVID patient and a Non-COVID patient. So, if a mortician is to transport a person out of a home there needs to be a clear understanding that any unknown reason of death, ie: heart attack, etc.; means the body is taken to the morgue to hold in case it is a COVID death. But, allowing morticians to be involved will move ambulance calls along faster.

This is definitely a rather difficult issue and I believe the governors need to talk to the public and track their illness occurrences and deaths much in the way New York Governor Cuomo does on a regular basis.

I am sorry this is such a burden, but, it is how we carry that burden that matters.