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Allright my friends,

Here's one for the "legal eagles" out there.... Had a call on friday wanting me to place a PICC on someone who was dying and needing it STAT.  After explaining to the caller that if the pt is a full code and needs a line, place a short term peripheral IV and call 911. The caller said no, we want her to die! After she dies we are going to give her IV antibitoics and IV reglan and hydrating fluids and then put down a NG and flood her stomach with peptoB and other ant-acids.  She will then be sent to another state to be frozen in hopes that 30 years from now the technology will be such that she can be brought back to life and live the remainder of her days in "full life".  (Pt is 83 and has a list of co-morbities and allergies longer than my arm).

I'm a LPN, the caller then declared, and said, "Can I give the medications IV push?"  We then explained that here in Missouri, IV push medications can only be given by the LPN under life threatening circumstances.  If she's dead, we said, "How is that life threatening?"

My concern with this is "should an RN be giving medications to a person once they have expired?" I know it won't result in any further demise of the pt than what has already occurred, but is there anything that is contraindicated that I'm not thinking of?

I told the LPN that I would be there in the AM to place the PICC, but I would not place it, if she was already dead.

(P.S. PICC line placed successfully in the AM --- and yes, she was still breathing!)




ann zonderman
Ann Zonderman, BSN, JD,

Ann Zonderman, BSN, JD, CRNI, LHRM first thoughts - this is one for the ethics experts besides appropriateness / physician orders available.  Placing the PICC with a valid order is one thing, but the post care being proposed is so far off the norm. 

Your company policy, risk manager, legal dept may be a place to turn if you are asked to administer medications after a pronounced death.  Simply, it does not sound appropriate.  The entire scenario needs to be considered, but from what you shared, it just sounds very strange and makes me wonder what is behind the request.  

 As a nurse I have never seen / heard of being asked to administer post mortem infusion. I would not want to compromise my license in the event of a legal inquiry/ action.   As a lawyer I would wonder the family motive for extreme measure for an 83 yr / with multi medical conditions. 

If a physician is prescribing such treatment, I think the physician should be the responsible party to carry out the plan.  I would consider looking for a specific protocol for cryopreservation that  should be followed, including criteria for enrollment and the steps to follow if this is an appropriate candidate. 

 This would also raise some reimbursement/ payment issues if no a private pay. 

The nurses should be practicing with in the scope of their licenses.  

 Nures need to practice with a valid physician order,  for a specific  patient . This is where the ethics evaluation would be vital.  Does death define that life is non- esistent and therefor, treatment is no longer within the purvue of the nursing role. 

It would be interesting to hear more on this case...


Ann Zonderman, BSN, JD, CRNI

Donna Fritz
Just a technical question .
Just a technical question . . . so with no circulation moving, where do we expect these infusions/meds to go???  Doesn't seem like there would be systemic distribution . . . .
Donna, Yes that was my


Yes that was my thought too.  The MD's order was written for a peripheral, a Midline or a PICC.

But, the Cryopreservation company was requesting a central line.

I didn't understand what good a Midline or peripheral would do either as fluids would circulate only by volume given, not because of blood flow.



I just googled
I just googled cryopreservation and thought I was reading a Robin Cook book.  Apparently when they inject whatever cocktail they have ordered, they do cpr to circulate the meds.  You can become a member for $1,250 and to be preserved its $28,000 for a lifetime member, not including the furneral directors cost.  Look up Cryonics institute. 
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