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Dead on arrival

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Noninitiation of resuscitation may be appropriate in certain situations when lividity, rigor mortis, decomposition, decapitation, or other signs of obvious death are present. Protocols should specify when EMS personnel should and should not initiate resuscitation. These guidelines should address special circumstances, such as hypothermia and trauma, in addition to medical arrests. Consultation with the direct medical oversight physician is prudent in unclear situations.

Protocols should also detail specific tasks that EMS personnel must carry out after noninitiation of resuscitation, including notification of police, the coroner, or the medical examiner. EMS clinicians should also receive training in notifying the next‐of‐kin or loved ones on scene that the patient is dead and in providing emotional support.

Emergency Medical Services

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