Question: In the last year I have been presented with two different special occurrences regarding vital sign absent patients.

The first one involved a patient who was VSA on our arrival. We were presented with a legal living will as well as a note provided by a Doctor stating “DNR”. Unfortunately there was no ministry DNR validity form. We completed a full medical TOR as the patient met the requirements and after I was informed by co-workers that I could have called for a medical TOR after the first no shock indicated. They stated this was covered under special occurrence. I have looked and found no evidence of this existing although this could be very handy. Does such protocol or language exist?

The second incident involved a patient that we witnessed from a reasonable distance to be VSA. Due to safety reasons we could not access the patient for approximately 45 minutes. The patient did not meet obviously dead and didn’t have a DNR. We performed a medical TOR. Again informed that this falls under special occurrence and we could have called for medical tor after the first no shock indicated.

I’d really like to know if this is an option. It would come in handy for similar instances.