Adult Medical Emergency Handbook - Scottish Intensive Care Society

END OF LIFE CARE
WHEN DEATH OCCURS - CARE GOALS
If you have a bleep, ask someone to hold it while you speak with the family. Turn off mobile phone.
GOAL
Family feel supported in
the decision to be alone
with the patient
GOAL
Religious/cultural issues
are identified
GOAL
Family supported and
advice given if they are
waiting for the Death
Certificate to be issued
GOAL
Arrangements for
organ donation or post
mortem if appropriate
GOAL
Declaration of serious
infection hazard to
undertaker.
GOAL
Family advised what
to do next (if they do
not wish to wait for the
death certificate)
GOAL
Advice given to the family
about what to do next
GOAL
Enquire whether the person
has support at home
Appendix 2
• Reassure them that they will be given all the time they need.
• Continue to make regular contact to provide support, but do not imply haste.
• Provide a separate private area to enable the family to be together.
• After a period of time ascertain if family still comfortable staying,
sometimes they are at a loss as to what to do or what happens next.
• Ask family if they would welcome support of minister/priest/other.
Religious/Cultural issues?
• Have they been identified?
(see “What to do after a death in Scotland Booklet” - Chapter 10)
• Medical staff will pronounce life extinct (PLE).
• Provide tea/coffee in separate room, to allow medical staff to confirm
death and issue death certificate to the family in private.
• Medical staff will assess whether the Procurator Fiscal should be
informed. The death certificate cannot be issued by hospital staff in
the event of the fiscal taking over the case.
• Using professional judgement as to the appropriateness, sensitively
ascertain if any arrangements have been made/discussed re burial
or cremation. If cremation is chosen, or if intentions are not clear, a
Cremation Form part B should be completed and sent to the mortuary.
It should not be handed to relatives. The mortuary will arrange for
Form C to be completed if a post mortem is not undertaken and will
give the cremation form to the undertaker.
• Ward staff return belongings as per policy* and give bereavement
booklet and invitation for bereavement support.
• If there is a possibility of organ donation or a post mortem
examination is thought desirable, discuss with the family.
• A cremation Form C is not required if a post mortem examination
has been undertaken but consultation with pathologist is necessary
for completion of Q8a in Form B.
Complete a care of the deceased form (infection certificate) and send
to mortuary.
• Advise to return at a mutually convenient time the next day.
• Inform them that any member of the family / friend can do this as it
is often too difficult for the immediate family.
Explain steps in booklet pertaining to registering the death and about
the role of the funeral directors.
Discuss whether contact with family /friends or GP is required for support.
If appropriate accompany to the end of the ward or to the car.
*If all the above have been addressed perform Last Offices identifying cultural beliefs and
spiritual needs (refer to manual if required)
Ensure remaining patients concerns are addressed
Initials Yes No If “No” record
Above Goals met a variance
(Code …)
adult medical emergencies handbook | NHS LOTHIAN: UNIVERSITY HOSPITALS DIVISION | 2009/11
287