Dead on arrival

Dead on arrival (DOA), also dead in the field and brought in dead (BID), is a term used to 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, 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.

DOA is also frequently used as slang to indicate a new item that was received broken, or that an idea or concept is a nonstarter. In this case, the acronym may stand for "Defective on Arrival" instead.

When presented with a patient, medical professionals are required to perform cardiopulmonary resuscitation (CPR) unless specific conditions are met which 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.

Regardless of the patient, 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.

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