CPR after rigor mortis

Specialties Geriatric

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Hello All, Do u know where I can find information referring to Long term care scope of practice for RN's? What is the policy on starting cpr after rigor mortis set in? Thank you:)

CPR after rigor? :bugeyes: That's just nuts! The facility where I worked for about 5 years allowed LPN's pronounce death.

I am a bit confused here. Massachusetts only allows RN's to pronounce, by state law. It has nothing to do with facility policy.

Can you give more information regarding LPN's pronouncing please?

Is the LPN calling the Doc with his/her assessment and the doctor is pronouncing the patient over the phone? In many states nurses RN or LPN are not allowed to pronounce patients. What they do is call the physician with their assessment (vitals, EKG, Pupils, and etc). The doctor will pronounce the patient over the phone based upon their assessment. So although it seems the nurse is pronouncing the patient, in reality its the physician.

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Specializes in Geriatrics.
Originally Posted by ragingmomster

CPR after rigor? That's just nuts! The facility where I worked for about 5 years allowed LPN's pronounce death.

I am a bit confused here. Massachusetts only allows RN's to pronounce, by state law. It has nothing to do with facility policy.

Can you give more information regarding LPN's pronouncing please?

In the nursing home I work at, we only have CNAs and LPNs(2, one of which is the DON) on the nursing staff. This said, if someone dies, an LPN in our facility can and does declare people dead; we have no one else to do so.

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A couple weeks ago at my job at the prison an inmate was found dead while breakfast trays were being passed. A medical emergency call came over the radio and I responded to that unit. The inmate was a 44 yr old morbidly obese male who had stated he had no medical problems and was on no medication, and also stated he used 8 bundles - 80 bags - of heroin per day. He had been at the facility for 24 hours, had c/o being "dope sick" and was on our opiate detox protocol meds. He was on his bunk, w/o pulse and respiration, pupils were fixed and dilated, severe mottling was present, lividity was present in dependent areas and rigor mortis was starting to set in - he wasn't in full rigor, but he wasn't "floppy dead" any longer either. I made the decision we would not begin CPR. Preliminary autopsy report shows and enlarged heart and several occluded vessels. But as it turns out the State views not starting CPR as an error. "No one dies on DOC property". So my new motto while at the jail job is "No one is too dead for me!" CPR will be initiated no matter what!

I think we should get t-shirts with that printed across the front, "No one is too dead for us!" ;)

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I think we should get t-shirts with that printed across the front, "No one is too dead for us!" ;)

You know, I'm really liking the t-shirt idea. Imagine the looks as people try to figure out what that means!!

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Specializes in Utilization Management.
You know, I'm really liking the t-shirt idea. Imagine the looks as people try to figure out what that means!!

They'd probably think we were trying to get converts.

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Hehe...think Brian would let us sell them on here? ;)

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In our state, you get an order from the MD a telephone order, stating attempts would be futile, do not start CPR. Some states require a paramedic to do this. If they are in rigor, I would only bag them, til medics arrived. You wouldn't be ableto compress the heart anyway.

why waste your time bagging if the air is going into the lungs and not being circulated? your rationale makes no sense.

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Well, I figured if I couldn't make it through nursing school, I would become a mortician.... there is a strange and overly informative book called "From Death to Dust". There is a whole section on the breakdown on the cellular and rescitative systems after death with time frames, including rigor mortis. Print it out for your overly enthusiastic instructor.... DNR's are, at times, godsends for nurses.

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Specializes in Pediatrics.
are you talking about the old guy who went into the bathroom and died while masturbating....the clerks girlfriend goes in there thinking its her boyfriend with a stiffee and has sex with a dead guy who has dead wood? lol

that's the one!!! the first few times i saw it, i didn't notice the dead wood in the ambulance, until the guy put the baseball cap over it.

kevin smith rocks!!!

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Hello All, Do u know where I can find information referring to Long term care scope of practice for RN's? What is the policy on starting cpr after rigor mortis set in? Thank you:)

Kentucky requires all wards of the state to be a full code status. Regardless let's use our common sense which is the majority of the critcal thinking process. As the RN you are responsible for your residents or patients. If you find someone who has expired and they are a full code, use your critical thinking skills. Do you like your career? Why is a staff member finding someone expired so long that rigor mortis has set in? You'd better start the actions of CPR (if they are to stiff, you will not be able to but go through the motions), call the family immediately and the doctor and pray the family is not smart enough to bring these questions to you in a court of law. If not sued or until such a time, I suggest you look to management for help training or hiring a more competent staff. Nobody care if you are or where short staffed. Find a new place of employment if you can't make a difference in your current place of employment.

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we teach in cpr courses that you dont have to do cpr if the following exists:

1. dnr order present (hard copy)

2. physician present and pronounces patient

3. rigormortis is present

4. severe trauma

but whats concerning to me is that you would find a patient in rigor mortis...how often do you check your patients? im guessing this is ltc, but still.....dont these people have meds, need to be turned, checked for incontinence or so forth?

also a facility that doesnt do bls? run from that facility as your well being is in risk. your educator needs to review the laws and practices revelant to resuscitiaton and do's and dont's. i could see a charge of abuse or negligence in a case of cpr to a patient with rigor mortis.

weird story..........ive got another one.

we got a stat page from the lab stating a patients potassium was 9.5. yes, potassium. we started to go into the room and they physician is walking briskly to the room as well (he got a page). we go in there and the patient had expired. the lab tech had drawn blood from a person that just expired. he just walked in there and stuck the guy and left.....didnt realize he was dead.

rigor mortis can set in after one hour of death.....it doesn't have to be that long and i am sure would also depend on the persons health status before death.

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CPR after rigor? :bugeyes: That's just nuts! The facility where I worked for about 5 years allowed LPN's pronounce death.

I am a bit confused here. Massachusetts only allows RN's to pronounce, by state law. It has nothing to do with facility policy.

Can you give more information regarding LPN's pronouncing please?

In New Jersey the RN can pronounce death in a long term care facility.....LPN's are not allowed to. Did u ever hear of a facility telling u RN can only pronounce death if there is a DNR?

Where can I find my state laws??

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