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We are now going to have a look at the recognition and management of life extinct. Remember, this is a very traumatic time. We may have family members, we may have partners, we may have children, we could have anybody involved in this. And also, it can happen at any time, in any sort of place. So we always have to remember dignity, we always have to remember to look after the patient and the family members at this traumatic time. And we also, if it happens in the public, remember that we have to try and keep people away and keep prying eyes. So a little bit of care needs to be taken with how we deal with the patient and what we actually do from this point on. Remember, you are not a clinician that is allowed to certify death. That is a paramedic or a doctor or a clinician with those skills. So until that time occurs, or until that person arrives on the scene, the patient is not certified as dead. Also remember that if time allows, if we are there quickly and we see this actually take place, then we are duty-bound really just to attempt resuscitation.

The times when we would not attempt resuscitation are times when rigor mortis has set in. Rigor mortis sets in anything from about 35 minutes, when the patient starts to go rigored or stiff and the joints start to cease up. So if the patient is cold and stiff, we wouldn't attempt a resuscitation. Decapitation is another one where we wouldn't attempt resuscitation. If the torso has come separated from the cranium or the skull, then we are not going to attempt resuscitation, because it is a futile process. And again, it is better to actually act with dignity and cover the patient up than it is to try and do something that's gonna be futile and not gonna work. DNRs and advanced orders, which we have already talked about in a previous video, is another reason we wouldn't start a resuscitation, but again, remember, if in doubt, we start resuscitation. The DNR or the advanced decision has to be with you and the patient at the time of the resuscitation.

Another reason that we would stop a resuscitation is if we are out on the moors or we are miles from nowhere and there is nobody to help us and no way that anybody is going to be able to come in and take over from us And we are becoming exhausted and tired and our own health and safety is at risk, then we can stop the resuscitation. It's futile, we are not gonna get any help. We may have been out here trying to resuscitate this patient for 30 minutes, but if there's no way we can communicate with the outside world, there's no helicopters or no mountain rescue nearby, then we would have to call the patient as being non-resucitationable, because we are in a position where we cannot carry on any further. But remember, they are not dead until they are warm and dead in hypothermia and we do everything we possibly can with mobile phones until the point where we physically, literally cannot do anymore. And it is perfectly safe and perfectly legitimate to then stop.

So always remember, dignity in death is a very important part. We cover the body up, we take the family to one side. We talk to the family. We keep people away. We make sure that nobody films or takes photographs from cameras. It is our responsibility now to make sure that the patient has a dignified end and is looked after, to the best of our ability and look after the patient, family, children as if they were your own. Talk to them, explain what happened. The situation needs to be managed by you at the time. It is very difficult, it is very stressful. And again, if this bothers you in any way, seek help yourself after the situation is finished.

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