Dealing with Death & Dying in Medical Education and Practice
© 2001 Kirsti A. Dyer, MD, MS
AMSA Convention March 30, 2001
Declaring a Death
With the Patient
1.  Identify the patient by the hospital ID tag
2.  Note the general appearance of the body
3.  Ascertain that the patient does not rouse to verbal or tactile stimuli.  
Avoid overtly painful stimuli especially if family members are present.  
4. Listen for the absence of carotid pulse.
5. Look and listen for the absence of spontaneous respirations.
6. Record the position of the pupils and the absence of pupillary light reflex.
7. Note the time your assessment was completed. 
 This will be recorded as the official time of death.
In the Chart/Medical Record 
1. Called to pronounce (name).
2. Chart findings of physical examination.
3. Note date and time of death.
4. Note if family and attending physician were notified.
5. Document if family declines or accepts autopsy.
6. Document if the coroner/medical examiner was notified.

Heidenreich C, Weissman DE. Death Pronouncement and Death Notification: What the Resident Needs to Know, November 2000. Available from: EPERC (End-of-Life Physician Education Resource Center)

Compilation of resources for this presentation and Website © 2001 Kirsti A. Dyer, MD, MS.
Journey of Hearts,