# "Suicide victim alive for 90 minutes after being struck by train" - Barrie, ON



## mariomike (8 Jun 2011)

Never good when the coroner tells you your patient is still alive...

"BARRIE, Ont. - Presumed dead, a suicidal Barrie, Ont., woman lived for more than 90 minutes after deliberately stepping in front of a slow-moving commuter train at the city's south-end GO station last year.
It wasn't until the attending coroner peeled back the white sheet that efforts began in earnest to save 42-year-old Stacey Thorogood's life, according to a newly released report on the woman's death.":
http://www.thebarrieexaminer.com/ArticleDisplay.aspx?e=3152342

Coroner: "Upon viewing the body, I noticed signs of life. Subsequently, I advised the paramedics on the scene."  :-[
"She was able to provide her first name and answer questions."


----------



## medicineman (8 Jun 2011)

I remember being at an EMS conference once where a speaker who was a paramedic with the LAFD was talking about initial trauma assessments...he'd show pictures from scenes, as they carried cameras on the ambulances, and say "How many of you think this guys is dead?"...9 times out of 10 we'd all put up our hands...then he'd say "So did we, then we heard (a snoring sound)".  As the saying goes, ASSUME makes an ASS out of U and ME.

MM


----------



## Jeremy360 (8 Jun 2011)

> A declaration of death was made without direct hands-on assessment.



I'm no paramedic, nor am I a Med Tech, but I do recall failing a practice test for Occupational First Aid Level 3 in British Columbia.  My mannequin had no pulse at the neck and I didn't check the imaginary wrist.  I don't know what the current policy is on checking in multiple locations, but not checking at all would likely fail anywhere.


----------



## Container (8 Jun 2011)

I was at a particularly bad rollover and had a situation where no pulse could be located and we were in the midst of packaging the body when it gurgled. And not the normal deadbody moving sounds but like an honest to god gurgle.

A second check of the eye showed just a tiny nystagmus. We then switched to getting the body to the hospital.

That person is still alive today. Creating havoc where ever she goes. I dont think its as easy as people think sometimes- when you are dealing with situation where there is meat everywhere and you have one person in two locations it can be hard to get a pulse over your own heartbeat in your fingers.


----------



## Jeremy360 (8 Jun 2011)

Container said:
			
		

> I was at a particularly bad rollover and had a situation where no pulse could be located and we were in the midst of packaging the body when it gurgled. And not the normal deadbody moving sounds but like an honest to god gurgle.
> 
> A second check of the eye showed just a tiny nystagmus. We then switched to getting the body to the hospital.
> 
> That person is still alive today. Creating havoc where ever she goes. I dont think its as easy as people think sometimes- when you are dealing with situation where there is meat everywhere and you have one person in two locations it can be hard to get a pulse over your own heartbeat in your fingers.



I can truly respect that.  After a few messes, with no fatalities at a construction site I had seen more than enough to avoid going Med Tech.  Judging by that article I don't know if that's the kind of scene that I could ever manage.  My apologies if I came off as condescending towards EMTs.


----------



## mariomike (8 Jun 2011)

In Toronto, "where great public inconvenience will result" the ambulance transports the deceased from the TTC subway, CNR - GO train lines, and "major thoroughfares in rush hour."


----------



## Staff Weenie (8 Jun 2011)

Years ago, I was the only person to stop at a two veh MVA. I checked the first veh and found an unresponsive 87 yo female - no pulse, no resp, no pupil reaction, and a very grey palor to her face. Based on her Medic Alert chain, I figured she'd had a cardiac event and was gone (thus causing the accident). I left her to help the 22 yo in the other car who had put her face through the windshield. When the firemen arrived after about 5-10 minutes, they started CPR on the old lady. I was totally floored when I found out that the official cause of death was attributed to punctured lungs from the CPR - I guess she was still alive all the time. Never assume anything.


----------



## mariomike (8 Jun 2011)

medicineman said:
			
		

> I remember being at an EMS conference once where a speaker who was a paramedic with the LAFD was talking about initial trauma assessments...he'd show pictures from scenes, as they carried cameras on the ambulances, and say "How many of you think this guys is dead?"...9 times out of 10 we'd all put up our hands...then he'd say "So did we, then we heard (a snoring sound)".  As the saying goes, ASSUME makes an ASS out of U and ME.
> 
> MM



Highlight mine.

We were never allowed to take souvenir snapshots: "No Toronto EMS staff member while on duty will photograph (digitally or on film) any scene or situation involving any patient or other person unless expressly authorized by the Chief or his designate."


----------



## medicineman (8 Jun 2011)

They were directed to by their Medical Director for trauma scenes, especially MVC's - these were work pics, not souvenirs.

Having worked at both ends, having that pic literally tells a thousand words about a scene.

MM


----------



## mariomike (8 Jun 2011)

medicineman said:
			
		

> They were directed to by their Medical Director for trauma scenes, especially MVC's - these were work pics, not souvenirs.
> 
> Having worked at both ends, having that pic literally tells a thousand words about a scene.
> 
> MM



Sorry, "souvenirs" was a poor choice of words.


----------



## medicineman (8 Jun 2011)

I'm not a big fan of taking pictures when working simply because I should be working and not taking pics...however I'd say that they should wake up a bit, because a photo of a car wreck can tell an ER doc or trauma surgeon alot of what injuries to expect, why it took so long to extricate or why something was/wasn't done on scene, etc all in a neat little package.

MM


----------



## mariomike (8 Jun 2011)

medicineman said:
			
		

> I'm not a big fan of taking pictures when working simply because I should be working and not taking pics...however I'd say that they should wake up a bit, because a photo of a car wreck can tell an ER doc or trauma surgeon alot of what injuries to expect, why it took so long to extricate or why something was/wasn't done on scene, etc all in a neat little package.
> 
> MM



You are absolutely right. There is a massive S.O.P. on the subject of "authorized" photography on scenes. Only Supervisors are authorized to take photographs.

The Deceased Patient Protocol is pretty straightforward:
"Upon completion of a thorough assessment, the paramedic may presume
death has occurred if gross signs of death are obvious, i.e. by reason of:
a) decapitation, transection, visible decomposition, putrefaction.

b) the absence of vital signs and:
i) grossly charred body; or
ii) open head or torso wounds with gross outpouring of cranial or visceral contents; or
iii) gross rigor mortis (i.e. limbs and/or body stiff and/or posturing of limbs or body), or
iv) lividity (fixed i.e. non-blanching purple/black discolouration of skin in dependent
area of body)."

This S.O.P. has been in the book for as long as I can remember. 

There is also a "fear factor" Paramedics face in some of these rescues. Not to say it was the case in the above ( crawling under a locomotive ), but I know the feeling.
Subway trains with electric third rail, 25 ton streetcars supported by air bags and metal bars, elevator accidents, highrise construction accidents, sewer accidents etc etc etc...
Especially in a big city with a century of above and under ground infrastructure, highrises, tunneling and linked transportation systems, 16 lane highways, the rescue scenarios faced are endless, and increasingly more challenging.


----------

