When you find someone who is unresponsive...

[litchi]

My mom gave me a call this morning and said that her neighbor had burst through the front door screaming that her husband, "Tom", needed help. My mom went across the street and found Tom laying face down on the ground with no pulse. He was also cool to the touch. His was a big guy, so she had to have his wife help her turn him over. Once they got him on his back, my mom said his nose had been shattered and he had bitten his tongue. The blood from his nose and mouth had already coagulated some. My mom tried to listen for any breath sounds, but there were none. He was apparently a black ashy color from about the neck up. An ambulance came and got him I think, but Tom didn't make it.

My mom was upset and said she'd wished I was there. I'm just a pre-nursing student, so about the only thing I would've known to do would be talk to the 911 operator or try to provide some comfort to the wife and Mom. Of course, my mom feels really bad.. like there was more that she should have done to save him. To me, it sounds like he was already dead by the time she got to him so there wasn't much she could have done.

I have a few questions regarding the situation, since I haven't made it that far in school and would actually like to know what a trained nurse would do.

Do you think this he was dead already? Would you still have performed CPR or done anything else under the circumstances? If someone is obviously dead, what do you do? They suspect a heart attack, but what would've made him turn a black color? Is that common in heart attacks, or did it have to do with him being face down?

If any of my questions are inappropriate or violate TOS, I apologize in advance.

Thanks for any answers you are able to provide.

[IHeartPeds87]

I'd just be wary of using names.....I'm a prenursing student myself so I can't really answer your other questions...

[litchi]

I'd just be wary of using names...

Taken care of, thanks.

[AngelfireRN, MSN, RN, APRN]

From what you describe, he was dead, graveyard dead. If they are that black color and already cool, they've been gone a while, typically. From the description you give, it sounds rather sudden, like he experienced a massive something and just fell WHAM!

I don't think that there was anything your Mama, your neighbor, or anyone but the Good Lord himself could have done. Please give her our best, she did all she could, and it's a terrible feeling.

[Coffee Nurse, BSN, RN]

I'm thinking the blackness was lividity. When a person dies and their blood stops circulating, it settles in the dependent (lowest) areas of the body. Since "Tom" was lying prone, it would have been his face. There's really nothing to be done, if someone is found at that point.

[morte, LPN, LVN]

i would suspect if he hit the ground hard enough to "shatter" his nose, and never made a sound.....he was dead before he hit.....

[docbkh]

I agree with the previous suspicions...

... from someone who's assessed more than a few individuals found possibly dead.

[AlabamaBelle]

There was nothing you could have done. He was gone, gone, gone.

[AlabamaBelle]

However, if you do find someone down and they are still warm, you can try CPR. Keep in mind, though, that out of facility resuscitations are rarely successful.

If you haven't already, you could take BLS. That will give you basic resuscitation skills.

[tewdles, RN]

Keep in mind that cold water drownings are an exception to the CPR thing....cold water drownings aren't dead until they are warm and dead...you find a cold water floater that is obviously recent, do CPR.

[nerdtonurse?, BSN, RN]

With the exception of the "you're not dead until you're WARM and dead" in hypothermic situations:

The survival rate for an out of the hospital situation where CPR is required is pretty dismal (http://www.americanheart.org/presenter.jhtml?identifier=4483). Where you are, how fast they got an AED to you (assuming a shockable rhythm), and how fast CPR is started after collapse; I unfortunately have seen a lot of people have MIs, and if you don't have telemetry to tell you the underlying rhythm, meds to change that rhythm, and an AED --If, that's IF -- you have a shockable rhythm to snap a pt out of VF, you're helpless.

I had a EMT tell me that sometime they do the CPR just so the family knows they tried to give the patient a chance (even if the person's been down way, WAY too long for anything to help).

[litchi]

Thanks for all the great responses, I really do appreciate it. I didn't even think of lividity as a possible reason for his coloration. My mom told me that she thought she'd seen him about 10 minutes earlier, but I think her time must have been a little off. She still feels bad about the situation, but she isn't as down on herself now that she knows there was absolutely nothing she could have done by the time she got to him.