Dead on arrival (DOA), also dead in the field and brought in dead (BID), are terms which indicate that a patient was found to be already clinically dead upon the arrival of professional medical assistance, often in the form of first responders such as emergency medical technicians, paramedics, firefighters, or police.
In some jurisdictions, first responders must consult verbally with a physician before officially pronouncing a patient deceased, but once cardiopulmonary resuscitation is initiated, it must be continued until a physician can pronounce the patient dead. Dead on arrival can also mean that a person is said by a doctor to be dead upon their arrival at a hospital, emergency room, clinic, or ward. A person can be pronounced dead on arrival if cardiopulmonary resuscitation or mouth-to-mouth resuscitation is found to be futile.
When presented with a patient, medical professionals are required to perform cardiopulmonary resuscitation (CPR) unless specific conditions are met that allow them to pronounce the patient as deceased. In most places, these are examples of such criteria:
This list may not be a comprehensive picture of medical practice in all jurisdictions or conditions. For example, it may not represent the standard of care for patients with terminal diseases such as advanced cancer. In addition, jurisdictions such as Texas permit withdrawal of medical care from patients who are deemed unlikely to recover.
Further information: Texas Futile Care Law
Regardless of the patient, a pronouncement of death must always be made with absolute certainty and only after it has been determined that the patient is not a candidate for resuscitation. This type of decision is rather sensitive and can be difficult to make.
Legal definitions of death vary from place to place; for example, irreversible brain-stem death, prolonged clinical death, etc.