Confirming Death

Question 1

Before you start

Answer 1

Confirm that 1 of the following criteria have been fulfilled
1. meets criteria for not attempting CPR
2. CPR has failed
3. Treatment aimed at sustaining life has been withdrawn as it has been decided that it would be to no further benefit to the patient

Introduce yourself to any family present and offer your condolences

Question 2

Approach

Answer 2

Wash hands, don PPE
Check patient ID with staff - ensure this matches the patient’s wristband

Verbal stimuli - Hello, Mr xxx, can you hear me

Question 3

Cardiorespiratory arrest assessment

Answer 3

Minimum of 5 mins - confirm the absence of
1. central pulse on palpation of the carotid
2. HS on auscultation
3. respiratory sounds on auscultatiom
4. signs of life - movement, respiratory effort

Use ECG monitoring, echo, and intra-arterial monitoring to supplement

Question 4

Cranial nerve response assessment

Answer 4

Bilateral absence of pupillary reflexes - pupils fixed and dilated
Bilateral absence of corneal reflexes - cotton on eye
Absence of any motor response to supraorbital pressure

Question 5

Documentation

Answer 5

Time of death - recorded at the time where all the criteria have been met

Document each step

Identity confirmed as xxx xxx from wrist band
DOB
Patient ID
Patient in bed, eyes closed, no signs of life or respiratory effort
No palpable carotid pulse for 5mins
No heart or respiratory sounds for 5mins
Pupils fixed and dialted
No corneal reflex
No response to supraorbital pressure

Death confirmed at xx/xx/xx at xx:xx