Nashville Fire Department Spells Out What ‘No Signs Of Life’ Means

Current protocol says that if patients’ injuries will result in certain death, they do not need to be taken to the hospital. The fire department is clarifying: Make sure they’re not breathing. Credit: Dave via Flickr

The Nashville Fire Department is updating its procedures of when it transports someone to the hospital. This comes after emergency responders left a man as dead Wednesday morning, though later they were called back because he was still breathing.

Paramedics and firefighters responded to a call at 3:04 a.m. about a Hermitage man with a gunshot wound to his head. After contacting a doctor from Vanderbilt, they deemed it an injury that was “inconsistent with survival,” said Corey Slovis, the fire department’s medical director.

“Vanderbilt, in accordance with national standards, has a trauma arrest protocol to avoid transporting patients who are already deemed unsalvageable with no signs of life,” Slovis said.

Corey Slovis, medical director of the Nashville Fire Department, gave a presentation earlier this year on when to transport patients and withhold CPR. Click to view.

That protocol is designed to minimize the cost of medical care when there’s no hope for survival. The only problem was, this particular patient did have signs of life: He was breathing.

The details on how this exactly the decision to leave him at the scene was made are still fuzzy. Both the fire department and Vanderbilt University Medical Center are investigating the incident.

But this much is known: The patient was finally brought to the hospital at 5:38 a.m., two and a half hours after the paramedics first arrived. He was pronounced dead just before 2 p.m.

The fire department did not provide reporters with a copy of the trauma arrest protocol used at the time. But this is how Slovis says it will likely be amended:

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In other words, the protocol will now explicitly say that only patients with no signs of life — no pulse, no respiration, no movement — should not be taken to the hospital.

“In the future, this patient should have and would have been transported, and we will make sure that the protocol is very clear about transportation,” Slovis said.