Death documentation - Revision history

Rossdonaldson1: /* See Also */

2026-03-25T20:23:23Z

Rossdonaldson1: /* Termination of Resuscitation */

2026-03-25T20:23:03Z

Termination of Resuscitation

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	==Termination of Resuscitation==		==Termination of Resuscitation==
	''For guidelines on termination of resuscitation, see [[Cardiac arrest]]''		''For guidelines on termination of resuscitation, see [[Cardiac arrest]]''
	~~8Document~~:		*Document:
	**Clinical rationale for terminating resuscitation		**Clinical rationale for terminating resuscitation
	**Duration of resuscitative efforts		**Duration of resuscitative efforts

Rossdonaldson1: /* Termination of Resuscitation */

2026-03-25T20:22:53Z

Termination of Resuscitation

← Older revision		Revision as of 20:22, 25 March 2026
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	==Termination of Resuscitation==		==Termination of Resuscitation==
	''For guidelines on termination of resuscitation, see [[Cardiac arrest]]''		''For guidelines on termination of resuscitation, see [[Cardiac arrest]]''
	~~Document~~:		8Document:
	*Clinical rationale for terminating resuscitation		**Clinical rationale for terminating resuscitation
	*Duration of resuscitative efforts		**Duration of resuscitative efforts
	*Any reversible causes considered and addressed (H's and T's)		**Any reversible causes considered and addressed (H's and T's)
	*Family input if applicable (family presence, request to stop)		**Family input if applicable (family presence, request to stop)

	==See Also==		==See Also==

Rossdonaldson1: /* Termination of Resuscitation */

2026-03-25T20:22:34Z

Termination of Resuscitation

← Older revision		Revision as of 20:22, 25 March 2026
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	==Termination of Resuscitation==		==Termination of Resuscitation==
	*Document the '''~~clinical~~ rationale~~'''~~ for terminating resuscitation		''For guidelines on termination of resuscitation, see [[Cardiac arrest]]''
	*~~Document the '''duration~~ of resuscitative efforts~~'''~~		Document:
	*~~Document any '''~~reversible causes~~'''~~ considered and addressed (H's and T's)		*Clinical rationale for terminating resuscitation
	*~~Document '''family~~ input~~'''~~ if applicable (family presence, request to stop)		*Duration of resuscitative efforts
	*For guidelines on termination of resuscitation, see [[Cardiac arrest]]		*Any reversible causes considered and addressed (H's and T's)
			*Family input if applicable (family presence, request to stop)

	==See Also==		==See Also==

Rossdonaldson1: /* Key Documentation Elements */

2026-03-25T20:21:05Z

Key Documentation Elements

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	*Date and time of death pronouncement		*Date and time of death pronouncement
	*Identity of pronouncing physician		*Identity of pronouncing physician
	*Method of confirmation: absent heart sounds, absent breath sounds, fixed dilated pupils, absence of response to stimuli		*[[Diagnosis of death\|Method of confirmation]]: absent heart sounds, absent breath sounds, fixed dilated pupils, absence of response to stimuli
	*Duration of examination (e.g., "auscultated for 1 full minute")		*Duration of examination (e.g., "auscultated for 1 full minute")
	*Family notification: who was notified, by whom, and when		*Family notification: who was notified, by whom, and when

Rossdonaldson1: /* Key Documentation Elements */

2026-03-25T20:20:40Z

Key Documentation Elements

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	==Key Documentation Elements==		==Key Documentation Elements==
	*~~'''~~Date and time~~'''~~ of death pronouncement		*Date and time of death pronouncement
	*~~'''~~Identity of pronouncing physician~~'''~~		*Identity of pronouncing physician
	*~~'''~~Method of confirmation~~'''~~: absent heart sounds, absent breath sounds, fixed dilated pupils, absence of response to stimuli		*Method of confirmation: absent heart sounds, absent breath sounds, fixed dilated pupils, absence of response to stimuli
	*~~'''~~Duration of examination~~'''~~ (e.g., "auscultated for 1 full minute")		*Duration of examination (e.g., "auscultated for 1 full minute")
	*~~'''~~Family notification~~'''~~: who was notified, by whom, and when		*Family notification: who was notified, by whom, and when
	*~~'''~~Medical examiner notification~~'''~~: whether notified, case accepted or declined		*Medical examiner notification: whether notified, case accepted or declined
	*~~'''~~Organ/tissue donor services~~'''~~ contacted per institutional protocol		*Organ/tissue donor services contacted per institutional protocol
	*Whether an ~~'''~~autopsy~~'''~~ was discussed with family		*Whether an autopsy was discussed with family
	*~~'''~~Personal effects~~'''~~ disposition		*Personal effects disposition

	==Pronouncement of Death (Non-Code)==		==Pronouncement of Death (Non-Code)==

Rossdonaldson1: /* See Also */

2026-03-25T20:18:02Z

Rossdonaldson1: /* See Also */

2026-03-25T20:17:24Z

Danbot: New page: Death documentation with pronouncement samples, code death documentation, ME notification criteria, termination of resuscitation

2026-03-24T10:57:37Z

New page: Death documentation with pronouncement samples, code death documentation, ME notification criteria, termination of resuscitation

New page

==Background==
*Death pronouncement and documentation is a routine but important responsibility of the emergency physician
*Proper documentation is required for legal, medicolegal, and public health purposes
*State laws vary regarding who may legally pronounce death and requirements for death certification
*The medical examiner/coroner must be notified in specific circumstances (varies by jurisdiction)

==When to Notify Medical Examiner/Coroner==
*Deaths due to trauma or injury
*Deaths of unknown cause
*Deaths not attended by a physician
*Deaths occurring in custody or detention
*Suspected homicide, suicide, or accidental death
*Deaths related to occupational hazard
*Deaths occurring during or after a surgical/medical procedure
*Deaths of children (especially those <3 years old)
*Deaths occurring within 24 hours of hospital admission (jurisdiction-dependent)
*Suspected abuse or neglect

==Key Documentation Elements==
*'''Date and time''' of death pronouncement
*'''Identity of pronouncing physician'''
*'''Method of confirmation''': absent heart sounds, absent breath sounds, fixed dilated pupils, absence of response to stimuli
*'''Duration of examination''' (e.g., "auscultated for 1 full minute")
*'''Family notification''': who was notified, by whom, and when
*'''Medical examiner notification''': whether notified, case accepted or declined
*'''Organ/tissue donor services''' contacted per institutional protocol
*Whether an '''autopsy''' was discussed with family
*'''Personal effects''' disposition

==Pronouncement of Death (Non-Code)==

===Sample Documentation===
I was called to pronounce patient @NAME@ (DOB: ___; MRN: ___).

At [TIME], I examined the patient and found: no spontaneous respirations, no heart sounds auscultated for >1 minute, pupils fixed and dilated bilaterally, no response to verbal or tactile stimulation, and no corneal reflexes.

Time of death: [TIME].

Family member(s) ___ were present at bedside / were notified by phone at [TIME] by [NAME].

Medical examiner was notified / not notified (not a reportable death). Organ procurement organization was notified per institutional protocol. Attending physician: ___.

==Death After Resuscitation (Code Death)==

===Sample Documentation===
Patient @NAME@ presented to the ED in [[Cardiac arrest|cardiac arrest]] with initial rhythm of ___. [[ACLS]] protocol was initiated including ___ rounds of CPR, epinephrine x___, defibrillation x___ at ___ joules.

Despite aggressive resuscitative efforts for ___ minutes, the patient did not achieve [[Return of spontaneous circulation|ROSC]]. Given the clinical scenario including ___ (e.g., prolonged downtime, refractory asystole, no reversible causes identified), the decision was made to terminate resuscitative efforts.

Time of death: [TIME].

Family was present at bedside / notified at [TIME] by [NAME]. The circumstances of the patient's death and resuscitation efforts were discussed with the family.

Medical examiner was notified at [TIME] and the case was accepted/declined. Organ procurement organization contacted at [TIME].

Total critical care time: ___ minutes (exclusive of separately billable procedures).

==Termination of Resuscitation==
*Document the '''clinical rationale''' for terminating resuscitation
*Document the '''duration of resuscitative efforts'''
*Document any '''reversible causes''' considered and addressed (H's and T's)
*Document '''family input''' if applicable (family presence, request to stop)
*For guidelines on termination of resuscitation, see [[Cardiac arrest]]

==See Also==
*[[Documentation for emergency physicians]]
*[[Critical care documentation]]
*[[Cardiac arrest]]
*[[ACLS]]

{{Documentation pages}}

==References==
<references/>

[[Category:Documentation]]

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	*[[Cardiac arrest]]		*[[Cardiac arrest]]
	*[[ACLS]]		*[[ACLS]]
			*[[Brain death]]

	{{Documentation pages}}		{{Documentation pages}}

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	==See Also==		==See Also==
	*[[~~Critical care documentation~~]]		*[[Diagnosis of death]]
	*[[Cardiac arrest]]		*[[Cardiac arrest]]
	*[[ACLS]]		*[[ACLS]]

← Older revision		Revision as of 20:17, 25 March 2026
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	==See Also==		==See Also==
	*[[Documentation for emergency physicians]]
	*[[Critical care documentation]]		*[[Critical care documentation]]
	*[[Cardiac arrest]]		*[[Cardiac arrest]]