Q: Our ambulance was called to a scene where it was clear that the person had died a natural death. Then they were almost immediately called to another scene with multiple victims. It wasn’t clear to our ambulance personnel if they could leave the deceased with next of kin so they could proceed to the next scene. What was the right thing to do?

A: The Iowa Department of Public Health statewide EMS protocols, which were updated in 2018, indicate that if an apparent death is confirmed, at least one EMS provider should remain at the scene until the “appropriate authority” is present. The same language can also be found under the section that relates to the termination of resuscitative efforts. The appropriate authority is typically defined in Appendix J as “medical examiner, funeral home, public safety,” or a similar entity or person.

However, the rules also appear to indicate that there is a potentiality that a body be left at the scene if the EMS is the only available unit and any delay in response to a more severe incident would be catastrophic. Appropriate plans on how to address this situation where compliance is impossible should be implemented by all EMS providers.