Death Verification
🚨 Life-Threatening — exclude first
If suspected, escalate now.
Do not verify if any spontaneous movement, respiratory effort, or pulse is present — reassess and escalate
Implantable defibrillators (ICD) may discharge after death — flag for deactivation
Unexpected, suspicious, or violent death — do not move lines/tubes, refer to coroner
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Before you enter Causes
Check the patient is expected to die / not for resuscitation (DNACPR documented)Confirm you are the appropriate clinician to verify (local policy)Bring the notes, a stethoscope, a pen torch and a watch with a second handAsk a nurse to accompany you
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Confirm identity Causes
Check name, date of birth and hospital number against the wristbandCross-reference with the notes and drug chart
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Confirm death Causes
No response to verbal stimulusNo response to painful stimulus (supra-orbital pressure or trapezius squeeze)No respiratory effort — observe chest and abdomen for a full minuteNo heart sounds on auscultation for a full minuteNo central (carotid) pulse for a full minutePupils fixed and dilated, unreactive to light
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After verification Causes
Record the exact time of death (time examination completed)Inform the nurse in chargeInform the next of kin (or confirm nursing team will)Flag any ICD / pacemaker for deactivation before mortuaryConsider coroner referral if unexpected, within 24 h of admission, post-op, or unclear causeComplete MCCD separately during normal hours (not part of verification)