Presumption of death by air medical transport teams.
BACKGROUND
The purpose of this study was to investigate nationwide trends and factors influencing the determination of death practice by rotor-wing air medical transport programs.


METHODS
A survey was mailed to all Association of Air Medical Service members concerning demographics, crew configuration, team leader, patient population, field death determination protocols, and other possible associated factors. All rotor-wing air medical transport programs that carry out scene transports were included.


RESULTS
The most common field presumption criteria were no response to advanced cardiac life support (77%), no signs of life on scene (65%), and asystole in 2 EKG monitor leads (61%). The most frequent reasons cited not to presume a patient dead in the field were political issues (71%) and signs of life on scene (56%). Criteria other than medical condition that were considered in the decision to presume death were ground personnel input (55%) and program policy/medical control (39%). The following factors did not significantly affect the presumption rate: crew configuration, team leader, transport time, billing, and type of medical control.


CONCLUSIONS
Medical criteria appear to determine presumption of death in the field. Nonmedical factors, such as billing, response, and transport times, do not affect this process.
Department of EMS/Trauma, Hartford Hospital and University of Connecticut School of Medicine, CT 06102, USA.
Kenneth J
KJ
Robinson
Dianne M
DM
Murphy
Lenworth M
LM
Jacobs
D017732:Air Ambulances / Q000592:standards* / Q000706:statistics & numerical data; D002965:Classification; D003643:Death; D004634:Emergency Medical Technicians / Q000592:standards* / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D011795:Surveys and Questionnaires; D014187:Transportation of Patients; D014218:Triage; D014481:United States