Verification of Expected Death

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

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Author End of Life Team 

Approved by the EOL & Bereavement Care Meeting 

Date of Publication 15/11/2022

Reference No PL/1447 (v1) 

Review Date 01/11/2025