101 Things the Fire Department wishes you knew



Friday, August 7

You Make the Call...Hanging

Dispatched to a report of a person hanging, you arrive to a local shop on main street which is closed up and the doors locked. A person waiting at the bus stop peered into the window, saw the man hanging and called 911.

After 10 minutes to break into the well secured shop you find a man who was successful in his last task in life, hanging from the rafters which he removed ceiling tiles to access. A note is found nearby and there is no sign of a struggle in the tiny shop.

The police are on scene and detectives are enroute when the ambulance crew asks you to help them cut him down to confirm he is lifeless, per protocols.

Should you cut him down before the detectives arrive? You make the call.

10 comments:

The Grumpy Dispatcher said...

Having just run a suicide call recently, the protocols we reviewed again are recent in my mind.

#1 - Patient care comes first. We all know the guy is dead, but CYA and serve the Pt first.

#2 - That said, it needs to be treated as a crime scene. Fire/EMS are the best scene spoilers around, but we don't always have to be.

Document EVERYTHING. All units should carry a disposable or digital camera. Photograph EVERYTHING before you touch or move it. With the ten-minute delay on entry, there is no excuse to not have the camera ready, so as to minimize delay of Pt care.

When the brothers in blue arrive, have ready a very detailed and complete record of the scene as found, and pictures to back it up.

Short answer: Go ahead and cut him down, but with FULL documentation.

Little Girl said...

There are always signs to look for that determine if the person is obviously dead or not.

I would say, if all the signs were there for an obvious death, you can delay cutting the person down until police are on scene.

SJMedic said...

Last hanging I ran on, I called in the air, he had an obvious neck fracture, he was cold, fixed/dilated pupils. Put on the monitor to confirm asystole and it was a done deal. It look less than 30 seconds. In my opinion, there is no reason to cut someone down who is obviously dead just to call them.

Betsey said...

I agree with the previous posters.
First, photo-document everything before you touch/disturb it.
Second, if you have protocols for in-field determination of death, that can be executed without taking the body down, do so (based on body temp, dependent lividity, rigor, etc.)
If you do have to take the body down and work the 'code', disturb as little as possible. If I had a tarp/blanket/clean sheet, my inclination would be to lay that out and put the body/run the code there, so that all your wrappers/debris will be on the sheet, and the evidence underneath will be less disturbed.

AdCy said...

According to our protocols, we cut our patients down. Doesn't always make sense, but it is what we are to do. I agree with the grumpy dispatcher.

Sad we even have a protocol about that...

brendan said...

If he doesn't meet my protocol's requirements for a determination of death (in other words, if I have to work him), he's coming down.

If the body displays the correct signs of death, he stays right where he is.

medicblog999 said...

What we are instructed to do is leave the patient hanging if OBVIOUSLY dead. The police surgeon or coroner will review the deceased prior to cutting him down.

However, if we have any doubt and want to resuscitate the patient then we can cut them down but have to ensure that we cut rope as far from the knot of the noose as possible as that is where the forensic evidence lies.

So in answer to your scenario. If obviously dead, leave well alone. If not then cut him down but preserve the knot!

Ben Yatzbaz said...

I agree with what's been said above - but learnt something new too! M999 - I didn't know the bit about the know - hope I don't have to remember about it any time soon...

medicblog999 said...

Ben,
As far as I remember, its to do with the obvious forensic material that can be found on the knot as that is where whoever has tied the knot has had their hands most (obviously!). But it is also to do with the way the knot has been tied and also the impression the knot leaves on the neck etc etc
We did a medical forensic course recently on our station, which was conducted by a retired CID (murder squad) detective, it was soooooo interesting and give us some really simple things to look for in sudden deaths to decide if they are suspicious or not.

TOTWTYTR said...

If he's dead and you're sure, leave him hanging. It's now a crime scene. If there is a chance that you'll be working him, then you have to cut him down. Pretty straightforward.