Quick Step by Step Guide to be completed within 1 hour following death
- Check ID of patient and if patient has implantable devices e.g., Implantable Cardiac Defibrillator (ICD). Ensure ICD deactivated.
- Ensure patient is flat and window in room is open.
- Stethoscope and pen torch available.
Examination Process
- Use pen-torch to test both eyes for absence of pupillary response to light. Check that pupils are fixed and dilated with no response to light.
- Use stethoscope to listen for heart sounds over clothing / night clothes, in centre and left side for 1 minute and repeat after 3 minutes
- Palpate for a central pulse at more than one location (carotid / femoral / brachial) for 1 minute and repeat after 3 minutes
- Observe for signs of respiration for 1 minute and repeat after 3 minutes
- If all of the above is confirmed perform a trapezius squeeze. Carry this out through clothing / night clothes.
The trapezius is a flat triangular muscle that covers the shoulder like a scarf. You grab this muscle firmly (not just the skin) with thumb and two fingers, pinch 1 or 2 inches and twist slightly.
If there is any spontaneous return of cardiac or respiratory activity during the above procedure observe for a further SIX minutes
Immediately after you have completed examination:
- Switch off syringe pump
- Complete required patient documentation including verification of expected death form, Care after death/deceased patient form and Notification of death / Infection Notification Form (Acute only).
Verification of death template completed on EMIS (Community only) - Notify Doctor of the death
- Provide support to family, loved ones and those close to the patient, including staff.
Offer keep sakes, information and guidance including:
“For You in Your Loss” booklet and also referral to Swan team for support. bfwh.SWANteam@nhs.net
Transfer care to the mortuary as soon as possible and within 4 hours
