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> Someone has to decide when life is extinct and when to start > resuscitation, and comments about decisions being made on the basis of a > list including finances is muddled to say the least. We need urgently to > provide a robust set of guidelines, if only to stop ambulance crews with > blue lights and sirens trailing bodies around the countryside. > Rowley, Firstly the guidelines currently in place for ambulance services seem to be roughly identical nationwide - I presume the model comes from the JCALC? They are robust, but clearly still err a bit on the side of caution. Secondly, the main problem Davy encountered was rejection of his "stop resuscitation order". How should one deal with this situation? I entirely agree that this case seems to have highlighted a need for "stop resus/ DNR " training in all first aiders and mountain rescue teams. But in the circumstances, he did the right thing which was to continue until all were in agreement. Unless you have more responsibility or a recognised and accepted role to declare death, most lay first aiders would continue until someone with the authority came and told them to stop. Para I respect and agree with all you say about the unacceptable dangers to crews running on blue lights to deliver a corpse to A&E, but would have thought previously posted guidelines currently in existence would prevent 90% of the cases you object to. Perhaps the cases coming in are from crews who lack the confidence or experience to be sure life is really extinct? I feel an audit coming on!! Do other A&E depts still find this a big problem? I'll gladly raise your concerns at the next paramedic steering committee meeting if you wish. Best wishes Jeremy %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%