1

Section
6
Crime Scene
Dead on Arrival (DOA)

EMERGENCY MEDICAL SERVICES

Project Polaris-I
Pre Hospital Care Training Guide

Prepared by:
Version:
Revision Date:

Arlan M Kimbongan EMT RN

01
01 October 14

CRIME SCENE
Suspected Crime Scene
Assure safety of all EMS Providers

Summon Law Enforcement if not

present
Standard precaution
Team Leader may request entry of safe
area to determine viability of patient.
Additional personnel must be within
visual contact
Summon additional EMS resources only
as absolutely required for patient care
Minimize personnel allowed access to
the scene to those who are absolutely
required for patient care and / or
assessment.

VIABLE PATIENT
Follow appropriate
treatment protocol
Remove from crime
scene as soon as
possible
Relay any information
regarding crime
obtained during
treatment to police as
soon as possible

MINIMIZE SCENE DISTURBANCES

Enter and exit scene in the same path
Do not go any other places within the
scene other than what is required for
patient care and / or assessment
Wear gloves at all times, put on prior to
entry and do not remove until after exit
Avoid pools of blood
Do not cut though knife or bullet holes
Do not go through patients personal
effects

DECEASED PATIENT
Refer to DOA
guidelines
Do not move body
CONTACT MEDICAL
CONTROL
DO NOT TRANSPORT
DOA

TRANSPORT

This guide shall be used when law enforcement personnel advised EMS that they have
responded to a crime scene, or EMS determines that a crime scene may exist. The purpose
is to ensure the protection of the patient welfare as well as to ensure the ability to conduct
an effective and through investigation of the crime.

EMERGENCY MEDICAL SERVICES

Project Polaris-I
Pre Hospital Care Training Guide

Prepared by:
Version:
Revision Date:

Arlan M Kimbongan EMT RN

01
01 October 14

DEAD ON ARRIVAL (DOA)

PURPOSE
EMS should not begin to resuscitate if any of the following criteria for death in the field are met for a
patient who presents pulseless, apneic and with any one of the following:
Decapitation
Massive crush injury of the head, chest or abdomen
Gross decomposition or putrefaction
Gross rigor mortis without hypothermia
Gross incineration
Severe blunt trauma
With DNR Order validated by on-line physician
PROCEDURE
In all cases, contact with Medical Control should be immediate and well documented. Attaching to
an AED may be possible in some cases. When the on-line or an on-scene physician states to do
nothing, it should be documented as the pronouncement of death. Once this is done, police should
assume control of the scene, and EMS may go back into service.

KEY POINTS
If a patient is in complete cardiopulmonary arrest (clinically dead) and meets one or more of the
criteria below. CPR need not to be initiated:
o Gross decomposition or putrefaction
o Gross rigor mortis without hypothermia
o Gross incineration
o Dependent lividity
o Severe blunt force trauma
o Injury not compatible with life (i.e. decomposition, burned beyond recognition, massive
open or penetrating trauma to the head or chest with obvious organ destruction)
If a bystander or first responder has initiated CPR or automated defibrillation prior to an EMSs
arrival and any of the above criteria (signs of obvious death) are present, EMS personnel may
discontinue CPR. All other EMS personnel must communicate with medical control prior to
discontinuation of the resuscitative efforts.
If doubt exists, start resuscitation immediately. Once resuscitation is initiated, continue
resuscitation efforts until either:
o Resuscitation efforts meet the criteria for implementing the TERMINATION OF
RESUSCITATIVE EFFORTS.
o Patient care responsibilities are transferred to the destination hospital staff.
o When a Dead on Arrival (DOA) patient is encountered. The EMS team leader, upon
assessment, should avoid disturbing the scene or the body as much as possible. Unless it
is necessary to do so in order to care for the victims. Once it is determined that the
victim is, in fact, dead, the ambulance officer members should move as rapid as possible
to transfer responsibility or management of the scene to the Police Department before
asking permission to leave.
o Pregnant patients estimated to be 20 weeks or later in gestation should have standard
resuscitation initiated and rapid transport to a facility capable of providing an emergency
C-section. EMS personnel are NOT Allowed to perform On-Scene C-Section.
o Victims of lightning strike, drowning or a mechanism of injury that suggested nontraumatic cause for cardiac arrest should have standard resuscitation initiated.
o If the patient is pronounced DEAD on scene, leave ETT, IV and other interventions in
place.

EMERGENCY MEDICAL SERVICES

Project Polaris-I
Pre Hospital Care Training Guide

Prepared by:
Version:
Revision Date:

Arlan M Kimbongan EMT RN

01
01 October 14

EMERGENCY MEDICAL SERVICES

Project Polaris-I
Pre Hospital Care Training Guide

Prepared by:
Version:
Revision Date:

Arlan M Kimbongan EMT RN

01
01 October 14