Death powerpoint presentation

8/22/2019 Death powerpoint presentation

1/18

Disposition:

DOA and ER Death


2/18

Death

is the irreversible cessation of

circulatory and respiratory

functions or the irreversiblecessation of all functions of the

entire brain, including the brain

stem


3/18

A person shall be medically

and legally dead if either:

In the opinion of the attending physician,based on the acceptable standards of

medical practice, there is an absence ofnatural respiratory and cardiac functionsand, attempts at resuscitation would not besuccessful in restoring those functions.

In this case, death shall be deemed tohave occurred at the time these functionsceased; or


4/18

A person shall be medically

and legally dead if either:

Republic Act 7170-Sec 2

In the opinion of the consulting physician, concurred in bythe attending physician, that on the basis of acceptablestandards of medical practice, there is an irreversiblecessation of all brain functions; and considering the absenceof such functions, furtherattempts at resuscitation orcontinued supportive maintenance would not be successfulin restoring such natural functions.

In this case, death shall be deemed to have occurred at thetime when these conditions first appeared. The death of theperson shall be determined in accordance with the

acceptable standards of medical practice and shall bediagnosed separately by the attending physician andanother consulting physician, both of whom must beappropriately qualified and suitably experienced in the careof such patients. The death shall be recorded in the patient'smedical record.


5/18

Dead on A rr ival (DOA)

Patients brought to EmergencyRoom without cardio-pulmonaryand brain functions. This will

include patients who did notrespond to initial resuscitation.Resuscitation is no longer doneto patients with signs ofRigor

Mortis, Livor Mortis, Algor Mortisand Decapitation and advancestate of decomposition.


6/18

IS THERE SIGNS OF:

Rigor Mortis, Livor Mortis,

Algor Mortis, Decapitation and

in advance state of decomposition

Patient

came

in to

ER

YES

NO

DNR

Pronounce

Dead

DOA

NO vital signs

Resuscitate

NOT revived

Decision to stop resuscitation depends on the MD.No standard time when to stop.


7/18

ER Death

refers to death of patient, occurring at theER, who is not yet admitted.

These include patients who arrived at the

ER with no detectable vital signs (BP, HR,and RR) but revived by initial resuscitativemeasures, but eventually died, regardlessof the time of stay.

Postmortem care shall be done by the ERnursing personnel.


8/18

NO SIGNS OF Rigor Mortis,

Livor Mortis, Algor Mortis, Decapitation

and in advance state of decomposition

Patient

came

in to

ER

YESNO

Observation

Pronounce

Dead

ER Death

Vital signs?

Resuscitate

Revived

* Patient is not yet admitted.

Not revived


9/18

Death of ADMITTED Patient

This is a death o f an adm itted patient

who is no t yet accepted or reached the

assigned ward.

For such cases, the morta l ity shal l becoun ted to the census o f the adm i t ting

Ward.

Scenarios Adm itted patient who dies at the ER

Adm it ted pat ient wh o d ies whi le on transpor t


10/18

Adm itted patient who dies

at the ER

death certificate shall be

accomplished by the ER Officer.

Reason: physician at ward has notyet seen and examined the patient

Postmortem care shall be doneby the ER nursing personnel


11/18

Adm itted patient who dies/

codes wh i le on transpo rt

the patient shall be brought andresuscitated in the nearest unit which hasan E-cart.

The physician who pronounced the deathof the patient shall accomplish the deathcertificate Responsibility of ER officer

The postmortem care shall be done by thenursing personnelin that unit. Patient shall not be brought back to the ER or to

the admitting ward


12/18

Report ing ER Death

Death certificate shall be accomplished bythe ER Officer, if there is a definitediagnosis.

Otherwise, it shall be issued by the

city/municipal health officer, or NBI or policecrime laboratory in a medico-legal case after theconduct of an autopsy.

Section 4, Chapter XXI-IRR, P.D. 856 ofthe Sanitation Code of the Philippines The death shall be reported to the local health

officer within 48 hours after death

the death certificate shall be forwarded to thelocal civil registrar concerned within 30 daysafter death for registration.


13/18

Role of ER Staff in case o f

ER Death

ER Officer and ER Nurses must completethe patient medical chart.

ER Officer must issue a death certificate ifthe diagnosis is certain; otherwise,mandatory autopsy is necessary before adeath certificate is issued.

ER Nurse facilitates billing, post mortemcare, and transfer of the cadaver to themorgue.


14/18

Role of the ER Phys ic ian in

case of ER Death /DOA

Refer all ER deaths for autopsy to thephysician (referred to as the Prosector) pathologist, hospital/NBI/PNP medico-legal

officer, or Provincial/City/Municipal HealthOfficer, who will do the autopsy

Must write on the chart/medical record ofthe decedent the indication for the autopsy.

Send a formal referral to the prosectorregarding the reason for the autopsy.


15/18


case of Death

Must clearly inform the relatives of thedecedent on the need for the autopsy.

If the relatives do not give informedconsent or have outright refusal on theconduct of the autopsy, the ER Officer orattending physician must indicate in thechart the reasons and consequences

The nearest of kin must sign a waiver forrefusing the conduct of the autopsy. Awaiver form may be adapted and revisedby the institution.


16/18


case of Death

Shall not give any detail on the procedureof the autopsy. Only the prosector will explain the procedure of

the autopsy.

Provide a clinical abstract, which mustinclude the circumstances surrounding thedemise, and laboratory and ancillary testresults including radiographs.

For mass casualty incident, properdocumentation of identification of thecadaver is deemed necessary.


17/18

Death due to Dangerous / Commun icable/

Infect iou s Diseases shal l be prop er ly disp osed of

wi th the fo l lowing advises:

The remains shall be buried within 12 hours afterdeath.

Only the adult members of the family of thedeceased shall be permitted to attend the funeral.

The remains shall be placed in a durable, air tightand sealed casket.

The remains shall not be taken to any place ofpublic assembly.

No permit shall be granted for the transfer of suchremains.


18/18

Documents

Death powerpoint presentation