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Verification of Death - Dr. James Gill
Jul 9, 2024
Verification of Death
Introduction
Lecturer
: Dr. James Gill
Topic
: Verification of death (clinical skill/OSCE station)
Note
: Sensitive content regarding death. Skip if recently affected by a family member's death.
Legal Context (UK Law)
Verification of Death
:
Not required to be performed by a doctor
Can be done by paramedics, certain nurses, and allied healthcare professionals
Doctor's Responsibilities
:
Not required to view the body after death or report the death has occurred
Doctor's role: Provide death certificate (usually the doctor involved in the patient's recent care)
Report to coroner if the cause of death needs investigating
Criteria for Verification of Death
Four key features confirming death:
Apneic
(no longer breathing)
Unconscious
(unresponsive)
Absence of circulation
Irreversibility
of the above
Communication and Sensitivity
Importance of Communication Skills
:
Family members might be present
Explain your role and offer them to stay or leave
Show respect and talk to the patient even if deceased (especially in front of family)
Examination Process
Confirm Identity
:
Verify with ward staff and ID bracelet (name, date of birth, hospital ID)
Check Responsiveness
:
Call out to patient
No response to voice
Pupil Response
:
Use pen torch; pupils should be fixed and dilated
Negative Stimuli Test
:
Apply supraorbital pressure (no response to pain)
Check Pulse
:
Use large bore artery (carotid or femoral)
Check both sides for one minute
Check Heart and Breath Sounds
:
Use stethoscope; listen for absence of heart and breath sounds (30 seconds on each lung)
Pacemaker Check
:
Look for pacemaker over clavicle and chest
Documentation
Record
:
Name and date of birth
Time and date of death
Verifier's details for contact
Key Points Recap
Confirmed features: apnea, unconsciousness, fixed and dilated pupils, absence of pulse
Verification of death is irreversible and includes thorough documentation
Additional Notes
Special Settings
: In ITU, brain stem death confirmation requires additional skills (beyond this lecture)
If questions arise, contact the medical school for further guidance. Share the lecture if found useful.
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Full transcript