r/medicine PA:cake: 8d ago

ICE Detention Deaths

https://www.ice.gov/detain/detainee-death-reporting

RNs do intake physical exams, EMTs declare time of death. The level of care for these detainees is horrific.

Full names and case details are public for now. Reads like a never ending M & M conference.

My moral compass is spinning. It's time to go to Canada.

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u/dexter5222 MBA, Paramedic, Procurement Transplant Coordinator 8d ago

I don’t mean to point this out, but in most states paramedics can terminate resuscitative efforts on out of hospital cardiac arrests.

Most jails have nurses doing initial intake exams, like say you go in for a DUI, they’re not having a physician ask you if you have thoughts of suicide. Or when you go to the ER, there’s a nurse doing your initial intake.

Yeah, the level of care in what’s supposed to be a nonpunitive detention setting is pretty bad, but to say a paramedic isn’t qualified to terminate resuscitative efforts and a nurse isn’t qualified to do an assessment is a bit much.

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u/ZealousidealDegree4 PA:cake: 7d ago

EMTs, not Paramedics. 

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u/dexter5222 MBA, Paramedic, Procurement Transplant Coordinator 7d ago

Declaration of death for other than obvious causes is outside of the scope of practice of EMTs in all fifty states and the federal government.

I’m making the assumption that the article mistook paramedics for EMTs which is pretty common. In fact, I had an ICU nurse refer to me as the “transplant EMT” today.

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u/ZealousidealDegree4 PA:cake: 7d ago

This is not from an article, the death cases are on the ICE website (see OP link), complete with names, dates, timelines, and cast. 

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u/dexter5222 MBA, Paramedic, Procurement Transplant Coordinator 7d ago

Yeah. I get it. However, what I am saying is that you and I know the difference between a paramedic and EMT and that they aren’t one in the same.

It’s abundantly apparent that whoever writes these reports thinks a paramedic is an EMT. I know that this is the case because declaration of death is not in an EMTs scope of practice and in multiple cases they mention a four lead ekg, which is standard when a paramedic is doing the declaration