Paramedics cannot pronounce a person dead unless there is an obvious decapitation, or rigormortis and/or decomposition has set in. With any cardiac arrest, paramedics and EMTs "work" the patient all the way to the hospital..that is giving CPR or possibly shocking with a defirilator. Even if the patient seems to be a "lost cause" it is not for them to call a death. Also, if the patient is an organ donor, CPR must be performed all the way to the hospital to keep the organs viable for transplant.