Want to watch this video? Sign up for the course here. Or enter your email below to watch one free video.

Unlock This Video Now for FREE

This video is normally available to paying customers.
You may unlock this video for FREE. Enter your email address for instant access AND to receive ongoing updates and special discounts related to this topic.

In this next video, we are going to talk about one of the softer skills surrounding resuscitation, and it's about the ethical principles that apply to how we do our job. We always operate under the guiding principles of beneficence and non-maleficence, which is, "Do only good and do no harm." And these principles apply to us in a resuscitation scenario. We should always make the best effort to resuscitate a patient. It's not in our gift to play God and to decide when somebody should be resuscitated or not.

There are some guidelines which help guide us in our decision-making process. These are different from organization to organization, in the ambulance service, in the pre-hospital care setting, we are guided by our JRCALC guidelines. And there are certain cases where we clearly do not need to start resuscitation, and these can be in incineration, decomposition, in hemicorporectomy, decapitation, and cases where clearly the patient is not going to be in a resuscitate-able state.

There are grey areas, however, where we should, if under any doubt whatsoever, give 100% maximum effort to resuscitating that patient. And in certain cases, we must always take the patient into a hospital setting. These cases are where we have a child or an under-18-year-old cardiac arrest, a patient with penetrating trauma, a patient who is pregnant, where our aim is to resuscitate the mother in an attempt to save the baby, even where the mother may fear. The previous criteria of where we wouldn't normally start CPR and other cases are where the patient is hypothermic and has been drowned or where poisoning is a cause of the cardiac arrest.

We must always remember the issue of confidentiality. It's not our role to declare the patient's death to neighbours, the members of the public, or other people on the ward. If in the pre-hospital setting, the patient has died and the situation looks like a crime scene, or a crime is taken place or any suspicious circumstances, then we must inform the police and protect the scene until the police arrive. However, we must also remember the preservation of life take precedence over any other thing. And our attempts at CPR and resuscitation should not be not started because it is a crime scene.

And finally, on this issue of ethics and legalities, we must remember to document everything that we do. Our defibrillators and monitors will continually record the activities, the ECG that we have done, the timings, the amount of shocks delivered, and this must be produced post incident, particularly if the patient dies, as this could well be used in the coroner's court as evidence.