4. Dying patient

Question 1

Treatments and investigations in dying patients

Answer 1

Do not over-investigate or over-treat dying patients

Question 2

Verifying death

Answer 2

• No response to verbal/painful stimuli
• Pupils fixed and dilated
• Absence of carotid pulse
• Absence of heart sounds for 2 mins
• Absence of breath sounds for 3 mins
  (Note: total auscultation time should be 5 mins to confirm cardiopulmonary arrest)

Question 3

Death certification.

a) Who can certify?
b) Section 1a
c) Section 1b/1c
d) Section 2

Answer 3

a) Registered doctor who cared for the patient in their last 14 days of life
b) Direct immediate causes of death (eg. pneumonia)
c) Conditions that directly caused all of the conditions listed in 1a
d) Conditions contributing to the death, but not related to the disease that caused it (e.g. DM in a patient who died of pneumonia)

Question 4

Reasons for reporting to the coroner.

a) 2 practical reasons
b) Cause of death
c) Place of death

Answer 4

a) - No doctor cared for them during their last illness
- Not seen within 14 days before death

b) - Cause of death unknown
- Death occurred during an operation or before recovery from the effects of an anaesthetic
- Death was sudden or unexpected
- Death was unnatural
- Death was due to violence or neglect
- Death was in other suspicious circumstances

c) - Death occurred at work or was due to industrial disease or poisoning
- Death occurred in prison, police custody or other state detention