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Certifying Clinical Death Process Guide

To certify a patient as clinically deceased, a physician must conduct a thorough physical exam and diagnostic tests to determine the absence of brain and cardiac activity. This includes examination of pupils, heart and lung sounds, and neurological reflexes. Additional signs of death like purpuric spots and rigor mortis may be present. The physician documents the cause and contributing factors of death on a death certificate, which is filed with local registrars or coroners depending on the circumstances of death. Autopsies may be requested to confirm identity, cause, manner, date and place of death.

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45 views1 page

Certifying Clinical Death Process Guide

To certify a patient as clinically deceased, a physician must conduct a thorough physical exam and diagnostic tests to determine the absence of brain and cardiac activity. This includes examination of pupils, heart and lung sounds, and neurological reflexes. Additional signs of death like purpuric spots and rigor mortis may be present. The physician documents the cause and contributing factors of death on a death certificate, which is filed with local registrars or coroners depending on the circumstances of death. Autopsies may be requested to confirm identity, cause, manner, date and place of death.

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anh.trannam6071
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© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Viva question: How do you certify a patient clinically deceased?

Process of diagnosing death: Complete physical exam in private space Cardioresp o Pulse: radial, carotid, femoral o Auscultate for heart and lung sounds for 1 min each, for at least 5 min o Absence of electrical activity in the heart Neuro o Eyes: dilated, fixed pupils; cloudy cornea, no corneal reflexes, loss of eyeball tension, fundoscopy reveal segmentation of retinal blood columns (2/3 of people dont display this sign, although v specific) o Brain death signs (absence of a variety of reflexes) o Absence of electrical activity in the brain Post death signs: o Purpuric death spots, rigor mortis (beginnings of), decreasing body temperature R/O: hypothermia, coma, metabolic derangement Death certificates 2 parts: o 1st part: cause of death, e.g. a) VF b) MI c) Coronary atherosclerosis o 2nd part: contributors, but not direct cause of death, e.g. smoking, obesity Forward it to funeral director or a local Registrar of Births, Deaths and Marriages (Registration of Births, Deaths and Marriages Act 1973). In NSW, not issued if: (i) Unusual circumstances: a violent or unnatural death (trauma, accident), suspicious circumstances, within a year and a day of an accident where the accident may have contributed to the persons death (ii) Safeguards: within 24 hrs of receiving an anaesthetic (local, general), in custody, from a mental institution (iii) Unknown: sudden and cause is unknown, deceased has not seen the practitioner for 6 months or longer If the practitioner cant sign it: o Report death to officer-in-charge of a police station, who will report the death to the Coroner (Coroners Act 1980) o Autopsies are performed in the majority of cases Aim to determine: identity, cause of death, manner of death, date, place of death Autopsies May be performed without any legal interest from the Coroner as part of a hospital autopsy under the Human Tissue Act

Anh Tran-Nam June 2011

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