the deceased patient in the ED

see also:

• death and the potentially dead
• end of life care
• medico-legal issues in the ED
• Western Health policies index for the deceased patient (intranet only)
  • Western Health's Death of a patient procedure (pdf)
  • Western Health's post mortem request flow chart (pdf)
  • Western health's procedure for organ donation after cardiac death (pdf)

• from the medico-legal viewpoint for ED doctors there are 3 scenarios:
  • deceased patients brought to the ED by undertakers for verification of death
  • patients dead on arrival (DOA) or dying in ED who are either:
    • reportable deaths to the Coroner, or,
    • non-reportable deaths
• ED staff are required for ALL 3 categories to "verify death" and document time of death by recording the absence of signs of life, and the actual time of assessment of the deceased state was performed (not the time the patient actually died) - this is NOT the same as certifying the cause of death!
• hospital staff should also consider discussing with family:
  • referral for organ donation
  • referral for post mortem if non-reportable death and cause of death needs further investigation
  • referral for support - spiritual (eg. pastoral care), psychologic and social
  • advice of how to contact a funeral director if it is not a reportable death
  • explanation of the Coronial process if it is a reportable death - see pdf
  • for perinatal deaths:
    • consent for the taking of swabs, blood samples, cord blood and placental samples
    • Claim for Bereavement Payment (Australian Government, Family Assistance Office). The Proof of Birth Doctor/Midwife declaration is to be completed by the midwife or doctor
    • Birth Registration Statement (Parent/s return to the Births, Deaths and Marriages Victoria, Department of Justice).
• if a ‘reportable death’ or a ‘reviewable death’ occurs and the body is in Victoria, the body is under the control of the coroner investigating the death until the coroner has issued an Order for Release of Body.
• most ED's will allocate an ED consultant to audit all deaths within the ED

• death and the potentially dead
• end of life care
• how to verify death
• verification of brain death in the ventilated patient
• reportable and reviewable deaths - deaths which MUST be reported to the Coroner
• how to complete a death certificate for cause of death

• the primary role of the ED staff for these presentations is to verify death - see how to verify death
• the undertaker will be responsible for further arrangements such as Coronial issues, or obtaining a Medical Certificate of Cause of Death from the person's usual doctor.
• the circumstances regarding the cause of death need not be ascertained by ED staff in detail.
• these patient's are given a Australasian Triage Category of 6.
• in reportable cases, bodies should not be removed from the scene of death until permitted to do so by the Coroner.
• there is no legal requirement for the funeral industry to obtain written verification that ‘cessation of life’ has occurred before moving the deceased body to a more appropriate location. However, it is to be expected that the funeral industry will require verbal reassurance that ‘cessation of life’ has occurred.