Death Verification
You are the FY1 on the gastroenterology ward.
Mr. John Thompson is a 47-year-old patient who was initially admitted under the gastroenterology team with a severe flare of ulcerative colitis. He deteriorated during his admission and was transferred to the surgical team for an emergency subtotal colectomy due to toxic megacolon. Following surgery, he was managed in ICU for complications including sepsis and multi-organ failure.
He was recently stepped down to the gastroenterology ward for ongoing care. A valid DNAR order is in place.
You are called by the nursing staff to assess him, as they have noticed no signs of life.
How would you verify Mr Thompson’s death?
PREPARATION
- Confirm patient identity (wristband)
- Check for valid DNAR
CLINICAL ASSESSMENT
🗣️ (Good practice but not mandatory)
- Assess response to verbal stimuli
🧠 For a minimum of 5 minutes, confirm absence of:
- Carotid pulse
- Heart sounds (auscultate for 1 full minute)
- Respiratory effort or breath sounds
- Signs of life (e.g., spontaneous movement, reflexes)
👁️ Assessment of Pupils and Motor Response:
- Fixed and dilated pupils
- Absence of motor response to supra-orbital pressure
AFTER VERIFICATION
Record time of death (when assessment is complete)
Document in the notes
Inform relevant nursing staff
Consider if the death needs referring to the coroner
Discuss with the consultant responsible for the patient or medical examiner if needed
How would you document the findings of the assessment?
Death Confirmation Assessment
- Identity confirmed as Mr. John Thompson from wristband
- DOB: 11/06/78
- Patient ID: 452-852-262
- Patient in bed, eyes closed, no signs of life or respiratory effort
- No palpable carotid pulse for 5 minutes
- No heart or respiratory sounds for 5 minutes
- Pupils fixed and dilated
- No response to supra-orbital pressure
- No corneal reflex
Death confirmed at: 21/04/25 at 06:45
Click here for more information on Death Verification
Click here to access the MTB webinar on DNACPR and Verifying Death
