Reviewing Death Confirmation Procedures - Osce Revision With Dr Gill

Death Confirmation Steps - Clinical Skills OSCE Revision - Dr Gill

Death confirmation is often tricky when it comes up as a clinical skills OSCE, especially as we tend to spend our time revising how to find what it wrong with people to treat them

HOWEVER medical school is more than just treating people, it is also about preparing for life as a working doctor, certainly in the first few years on the wards confirming death is something you WILL have to do with regretable regularity

Verifying and confirming death is essential to work for the doctor, but each country will have its own slightly different legal framework. This video reviews how to confirm death in the UK

#drgill #clinicalskills #death

00:00 - Introduction
01:10 - Legal Aspects of Verifying Death in the UK
03:12 - Four Features of Confirmed Death
03:55 - Communication Skills in Verifying Death
05:29 - Patient Verification Process
06:59 - Initial Patient Response Check
07:22 - Checking Pupillary Response
08:00 - Confirming Lack of Pulse
09:05 - Listening for Heart and Breath Sounds
11:42 - Final Checks for Pacemaker Presence
12:02 - Documentation of Death Verification
12:34 - Summary of Examination Findings
13:20 - Additional Skills in ITU Setting

[feminico]

props to the guy who had to die for this video. The world needs more professionals like him with that kind of dedication.

[jtcb.t]

Shoutout to the guy on the bed. Outstanding performance

[ESKATEUK]

The fact this guy gave his life for this video is incredible. Mad respect

[kmcg]

Really appreciate the warning at the beginning, but this actually brings me a great sense of calm and reassurance. I lost my mum about three years ago now (feels more recent) and the respect and professionalism shown here actually strangely makes me feel more comforted to know that she was taken care of at the end, because she passed before any of us could be there. The respect doctors and healthcare workers (and those in the funeral industry) show to every person is wonderful. I know the NHS doesn't always get things right with every case but this reassures me.

[samanthasavage]

Let me tell everyone who may have to do this one day, as an RN who has had to confirm death, those are the longest minutes of your life, all of the family is watching you, you may be crazy busy, you may be having the worst day- but I promise you aren’t having as bad of a day as the family in that room. Take a few extra minutes before you run out to confirm that the family is ok, and that you put the patients blankets/shirt back on. It preserves dignity and provides comfort to the family, who will often remain bedside post expiration for a while.

Our care also does not end with death, for example we do a post mortem wash of patients. You can ask the families if they wish to help at this stage, it often fosters feelings of closure and closeness, especially for people who’s love language is acts of service.

[bexgrant]

I imagine this is not an easy thing to do, but I'm glad that it is done with dignity and respect as you have shown here. Thanks Dr. Gill - very informative - my neighbour is a hospice nurse so this is an interesting perspective to see.

[ButterflyA]

I work in a nursing home and have watched my nurses verify deaths several times. One interesting thing many of those deaths have in common is difficulty confirming the stopping of breathing and heartbeat. Most of our patients are given morphine to manage pain in their last days; morphine can drastically slow and weaken both respirations and heartbeat. With little old people, that slowing and weakening can be _incredibly_ drastic. Once, my nurse took three minutes sitting with her stethoscope before finally declaring the patient still alive, though the patient did ultimately pass less than an hour later. Definitely one of the most difficult things a nurse in long-term care has to do!

[jrawlins]

I performed this examination on myself and I'm saddened to report...Dead.

[AL-jovp]

My dad died in 2019 of lung cancer. I remember watching his last breath and then going and getting the doctor to verify death . I don't remember them doing quite so much but they probably did. This video does make me relive it and it was traumatic (I couldn't get his eyes to shut so we left him staring at the ceiling which was horrible), but it's also still interesting from a medical perspective. It will happen to us all eventually!

[Michaelthekiwi]

My father died last year after a long illness, while it was expected it also happened very suddenly one night. The rest home hospital nurses confirmed death had occurred and called me. It's nice to see this demonstrated as they had always been very caring and professional while helping my father, this would have been the final act of care for him.

[nricardoe]

I have to say that I'm an engineer, nothing related with medicine, but Dr Gill makes every topic so interesting, that I watched the other exam videos, superb work Dr and my congratulations, your videos reaches people like me, not medicine but intestedoin it. Congrats from Colombia!

[zzgigs]

My daughter died in my arms a year ago, and her doctor was kind and let me hear her heartbeat before she died. I bought a stethoscope later on to remember that experience and found this channel while trying to learn how to use it.

I will never forget seeing her vitals decline and watching my own child slowly slip away, despite how hard she was fighting for life. I had only held her for two hours, carried her for five months. Those memories will never fade.

Hold your people close 🤍 Love them with all you've got.

[ConkerKing]

'Hello, my name's Dr Are you dead ?'

[starfishgurl]

When my uncle dropped dead suddenly mid conversation at work 4 years ago and wasn’t able to be revived at the hospital my dad was told that the paramedics did everything they could and then a doctor worked on him with the assistance of a nurse far longer than was probably necessary and they even had a chaplain perform last rights on him in the process and as sudden and shocking and traumatic as that was to experience it was very comforting knowing that they did everything they could for him and treated him so well in his final moments. It’s nice to see the confirmation process and how it’s gone about because for me it’s cathartic in processing his death which initially I didn’t understand due to shock and took some time to truly sink in. Thank you so much for sharing this!

[suzieq]

The mention of finding a pacemaker is important. Some pacemakers have a defibrillator built within it. Once death is confirmed, I understand a strong magnet is held over the pacemaker/defibrillator in order to make it stop trying to restart the heart ❤ Not all pacemakers have defibrillators which would then make the need of a strong magnet unnecessary.

[dingle]

Fascinating to see how doctors do it in hospitals, our process in the Ambulance Service is similar but has some differences; we'll almost always take a 4 lead ECG to verify asystole since we always have the monitor with us anyway. The way one speaks to the patient's family during and after the exam can make all the difference, and compassionate professionalism is an essential part of verifying death in my opinion.

I hope you'll forgive an anecdote.

We were called first thing in the morning to an elderly gentleman who had been found not breathing by his wife of over 60 years. We found him in bed, cold and rigored, having clearly died several hours previously in his sleep, I spoke to his wife, who I think already knew what had happened, and her biggest concern was that she had wasted our time. Nonsense of course, we made her a cup of tea and sat and discussed him and his life together while she made a few phone calls and waited until her family arrived. The bit that I have never forgotten was his pose in death; he had died cuddled into his wife, with his arm draped over her and body formed to hers, and the rigor mortis preserved the peaceful serenity of his passing for me to see. I felt great joy at having witnessed a love that had endured so many years, but also a sadness at having been the one to put an official end to it. We occupy a fleeting but unique position in the lives of the families left behind, and I think it's important that we treat that with the reverence it deserves.

[matthewmacdonaldchannel]

The content warning is massively appreciated, Dr. Gill. I love your content, but I was nervous about watching this. Thankfully, you were respectful and empathic, as always, and I learned a lot. Happy holidays to you and yours.

[grf]

I learn something interesting from every video. I would never have guessed that a family member would choose to remain in the room while the doctor confirmed death. I'd want to be a million miles away, but appreciate the fact that Dr. Gill gives the family the option to remain or leave.

[domself]

I find this very comforting, my dear Dad died suddenly 2 years ago, my Mum phoned me 3 or so hours after he died (I was at work, I'm a postman and was busy) She didn't know what was done to him after he passed as obviously she was in shock as she had just lost her life partner of 50 years. So thank you for uploading this, as I know Dad was treated with dignity after he died. x

[momtomtse]

Handled the topic with respect, like the professional you are. Thank you.