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Comment by GavinMcG | Hacker News Reader

In emergency medicine, you've got patients who are dead, and patients who are dead dead.

Patients who are just dead might still be brought back. This isn't about them. Patients who are dead dead because they haven't responded to resuscitation efforts aren't going to be taken to the hospital, is all. And in a lot of places that's already the norm.

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Isn't the instruction in fact to limit resuscitation efforts to in field? To take it to an extreme, if someone collapses and has a heart attack near a hospital, by this instruction they would have to revive the person (get a pulse/breathing) before transporting them to a hospital.

It sounds very different to what normal procedure would be. I am assuming that usually they try to get the pulse back but that they can continue to do that while in the ambulance (at least that's how it works in the movies). This change would limit that.

Movies give a very unrealistic example of chance of survival after heart attacks or cardiac arrest.

People are likely to survive one, but not the other. You wouldn't know that from film where almost everyone survives.

Could you specify which one they survive, possibly using "former" and "latter"?

A ‘heart attack’ is an episode of myocardial ischaemia (restricted blood supply to the heart) usually through a blockage of an artery. Angina is a pain associated with myocardial ischaemia of a usually temporary nature. A cardiac arrest is the stoppage of the heart.

Lots of people survive the first (apart for the 250,000 Americans for whom the first presentation of heart disease is sudden cardiac death), not so many survive the latter

Normal procedures for emergency cardiac care are going to vary depending on where you are in the world.

The general dichotomy is "stay and play" vs "scoop and run".

https://doi.org/10.1007/978-88-470-2215-7_31

Transporting these patients (the ones whose pulse hasn't returned in the field) appears to worsen their chances.[0] States vary widely in what protocols they require, but normal procedure in a lot of places is to not transport if resuscitation in the field has been unsuccessful.

[0] https://www.cardiovascularbusiness.com/topics/electrophysiol...

I feel like there's a quote from "Princess Bride" in there but I guess now is not the time.

Don't they need to be brought to the hospital for organ donation though ?

The circumstances in which organ donation is viable are surprisingly rare. I have a friend who worked in a head injury specialist unit, naturally this was a pretty good source of donors. You ideally need someone who is alive but only by virtue of life support so that you have time to turn off the machine and get the processes started.

This would be the case only in those countries where everyone is a donor by default (unless explicitly you opt out).

I don't think most countries have laws like that though.

The state where I live has opt-in organ donation option when you apply for a driver's license/state ID. As a retired EMT in a rural area, I encountered organ donation cases twice in my career. Once, the patient was flown out, the other time, the orgqan donation crew was flown in. The first case, the patient had suffered a gunshot wound to the head that spared the autonomic functions, he was breathing on his own.

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