2. Check the identity of the patient with the ward/nursing staff, and ensure this matches the identity of the patient by checking their wristband.
3. Assess the patient’s response to verbal stimuli e.g. “Hello, Mr Smith, can you hear me?” (response to verbal stimuli is not part of the formal process but is good practice as a first approach to the patient)
4. For a minimum of five minutes, confirm the absence of:
Central pulse on palpation (carotid artery) Heart sounds on auscultation Respiratory sounds on auscultation Signs of life (e.g. movement and respiratory effort) The carotid pulse can be located between [The carotid pulse can be located between the larynx and the anterior border of the sternocleidomastoid muscle.]
Asystole on continuous ECG monitoring Absence of pulsatile flow using direct intra-arterial pressure monitoring Absence of contractile activity using echocardiography 5. After five minutes of cardiorespiratory arrest, confirm:
a. Bilateral absence of pupillary reflexes using a pen torch (after death, the pupils become fixed and dilated) b. Bilateral absence of corneal reflexes using a piece of cotton/paper c. The absence of any motor response to supraorbital pressure
6. The time of death should be recorded as the time at which all these criteria have been confirmed.
DOCUMENTING DEATH CONFIRMATION Identity confirmed as Grace Smith DOB 11/06/90 PATIENT ID 555-452-332 The patient is in bed, eyes closed, with no signs of life or respiratory efforts No palpable carotid pulse for 5 minutes No heart or respiratory sounds for 5 minutes Pupils fixed and dilated No corneal reflex No reponse to supraorbital pressure Death confirmed