11/13/24, 7\:00 PM Guide | Death confirmation

Death con

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Background

According to the Academy of Medical Royal Colleges (AoMRC), death is the irreversible loss of essential characteristics which
are necessary to the existence of a living human person.
Therefore, the de
the irreversible loss of the capacity to breathe. Death may be secondary to a wide range of underlying problems in the body.
1
This means that whilst the end point of death is always within the brain, it can be diagnosed using circulatory, neurological or
somatic criteria to identify situations that will lead to the irreversible loss of the capacity for consciousness and the irreversible
loss of the capacity to breathe.
Con
undertaken using the circulatory criteria approach described below.
2

Before death con

Before con
The patient meets the criteria for not attempting cardiopulmonary resuscitation (e.g. the patient has a Do Not Attempt
Cardiopulmonary Resuscitation (DNACPR) form)
Attempts at CPR have failed
Treatment aimed at sustaining life has been withdrawn as it has been decided that it would be to no further bene
patient
If family or friends of the patient are present, introduce yourself and o
death and o
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Death con

To perform death con
1. Wash your hands and don PPE if appropriate.
2. Check the identity of the patient with the ward/nursing sta
their wristband.
3. Assess the patient’s response to verbal stimuli e.g.
“ H e l l o , M r S m i t h , c a n y o u h e a r m e ?” (response to verbal stimuli is not part
of the formal process but is good practice as a
4. For a minimum of
Central pulse on palpation (carotid artery)
Heart sounds on auscultation
Respiratory sounds on auscultation
Signs of life (e.g. movement and respiratory e
The carotid pulse can be located between the larynx and the anterior border of the sternocleidomastoid muscle.
In a hospital setting, if appropriate equipment is available, this can be supplemented with one or more of the following\:
Asystole on continuous ECG monitoring
Absence of pulsatile
Absence of contractile activity using echocardiography
5. After
Bilateral absence of pupillary re
Bilateral absence of corneal re
The absence of any motor response to supraorbital pressure
6. The time of death should be recorded as the time at which all these criteria have been con
Corneal re
The corneal re
consensual blinking). The a
branch is mediated by the temporal and zygomatic branches of the facial nerve.
To assess the corneal re
1. Gently touch the edge of the cornea using a wisp of cotton wool.
2. The absence of a blinking response would be expected in the context of death.
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Wash hands and don PPE if appropriate

Documentation

Once you have completed the required steps to con
Document each of the steps you performed and the result of each step. Then document that death has been con
including the time at which this occurred.
Your hospital may require you to propose a medical cause of death in the notes for review by the medical examiner.
Sign and print your full name, grade, registration number and contact number.
Read our guide to documenting death con for more details.
Document death con
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To complete death con

Inform the relevant nursing sta
inform the next of kin.
Consider if the death may need referring to the coroner. If this is the case, a death certi
should discuss the situation with the consultant responsible for the patient and the medical examiner.
To learn more about completing a death certiour guide.

Reviewer

Dr Steven Gill
Consultant in Intensive Care Medicine and Anaesthesia
Clinical Lead for Organ Donation (Education)
Nottingham University Hospitals

References

1. Academy of Medical Royal Colleges. Code of Practice for the Diagnosis and Con
from\: [LINK].
2. Treatment and care towards the end of life\: good practice in decision making. General Medical Council 2010. Available from\:
Source\: geekymedics.com
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