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Hallelujah Package

August 4, 2009

Last week, amidst the furore surrounding the investigation of pop icon Michael Jackson’s sudden death, Los Angeles City Fire Department spokesperson Captain Steve Reuter gave an off-camera interview to CNN during which he described the steps LAFD paramedics took to revive Mr. Jackson.  I have little interest in the demise of celebrities or entertainment industry gossip generally, but it was hard to escape the wall-to-wall coverage of accompanying Mr. Jackson’s death.

That helps explain why Captain Reuter’s comments caught me by surprise.  In his interview, Captain Reuter was quoted as saying that Mr. Jackson received the “hallelujah package.”  Now it isn’t unusual for emergency medical services to deliver a tiered response.  Most agencies deliver at least two levels of service depending upon the severity of the emergency and the availability of units to respond.

At the lowest level, trained responders will attend to give basic life support services: the ABC’s — airway, breathing, and circulation.  In many cases, these responders can also treat other life-threatening conditions by staunching bleeding or immobilizing victims of traumatic injury.  The most advanced level of care involves administering drugs to alleviate pain, restore or stabilize aberrant heart rhythms, replace fluids lost to bleeding, and insert tubes to assist breathing.

By all available accounts, Mr. Jackson needed advanced life support.  Captain Reuter indicated LAFD paramedics spent 42 minutes on the scene under the supevrision of Mr. Jackson’s personal physician attempting to resuscitate or stabilize him before transporting him to the hospital where he was later pronounced dead.  This description does not seem all that unusual.  Paramedics would usually spend less time on scene, but they don’t often have a physician on-scene directing their efforts, which would presumably slow things down a bit or contribute to less sense of urgency.

This begs the question, “What kind of care comes with the hallelujah package”?  Does this imply Mr. Jackson was beyond help and paramedics intervened to avoid criticism of their response.  Or does it suggest that celebrities receive a higher level of care than other mere mortals?  Either way, the use of the term raises ethical questions.

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