Verification of Death Processes and CPR Guidelines
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Questions and Answers

Which of the following situations indicates that resuscitation may be inappropriate?

  • The patient was in a car accident.
  • The patient has been unconscious for 5 minutes.
  • The patient showed signs of improvement before the ambulance arrived.
  • The patient has a valid ReSPECT form. (correct)

    • Asystole for more than 30 seconds indicates the potential for successful resuscitation.

    False

    What are the three processes that occur when someone dies?

    Clinical confirmation of death, certification of death, registration.

    Verification of death includes situations where there is no realistic chance that CPR would be successful if more than _____ minutes have elapsed since the onset of cardiac arrest.

    <p>15</p> Signup and view all the answers

    Match the following terms with their definitions:

    <p>Clinical confirmation of death = Clinically confirming that death has occurred Certification of death = Documenting the cause of death Registration = The legal process to record the death</p> Signup and view all the answers

    In which situation should verification of death NOT be completed?

    <p>Pregnancy</p> Signup and view all the answers

    CPR should be paused for a 60 second asystole check.

    <p>False</p> Signup and view all the answers

    What should be documented in the Patient Report Form regarding resuscitation practices?

    <p>Changes in resuscitation practices</p> Signup and view all the answers

    Name one sign unequivocally associated with death.

    <p>Decapitation</p> Signup and view all the answers

    A __________ is a decision that advises not to attempt cardiopulmonary resuscitation.

    <p>DNACPR</p> Signup and view all the answers

    Temperature is a definitive diagnostic criterion for determining death.

    <p>False</p> Signup and view all the answers

    What should be included in the additional information box if using an old LA3 form?

    <p>Updated practice information, such as 30 minutes ALS.</p> Signup and view all the answers

    Match the conditions that dictate the decision to not attempt CPR with their descriptions:

    <p>DNACPR = Decision against CPR ADRT = Advance decision to refuse treatment LPA = Lasting power of Attorney for Health &amp; Welfare Final stages = Irreversible condition where CPR is inappropriate</p> Signup and view all the answers

    What is a possible reason to not transport a patient to A&E?

    <p>The circumstances would make transport futile</p> Signup and view all the answers

    In the case of unexpected death, a __________ referral must be made.

    <p>safeguarding</p> Signup and view all the answers

    Hypothermia as the primary cause of death allows for the completion of verification of death.

    <p>False</p> Signup and view all the answers

    Match the following sections with their respective focus:

    <p>Section A = Criteria for verifying death Section B = Documentation procedures Section C = Resuscitation updates Section D = Patient care standards</p> Signup and view all the answers

    List one condition that would signify resuscitation should not be attempted.

    <p>Presence of a DNACPR decision</p> Signup and view all the answers

    Which of the following is NOT an essential criterion for verification of death?

    <p>Patient movement</p> Signup and view all the answers

    A death must be documented on the EPCR only if it was unexpected.

    <p>False</p> Signup and view all the answers

    Name one drug commonly used in End of Life Care (EoLC).

    <p>Morphine</p> Signup and view all the answers

    The pupils must be _______ and _______ during verification of death.

    <p>fixed; dilated</p> Signup and view all the answers

    Match the following types of death with their descriptions:

    <p>Expected Death = Anticipated as a result of disease progression Unexpected Death = Not related to a known illness or unnatural causes</p> Signup and view all the answers

    Which of the following elements is NOT part of the verification of death process?

    <p>Pupils responsive to light</p> Signup and view all the answers

    Rigor mortis must be present to verify death.

    <p>False</p> Signup and view all the answers

    What is the minimum duration for the ECG trace to confirm asystolic rhythm?

    <p>30 seconds</p> Signup and view all the answers

    Documentation of the death decision must include evidence from the ________ and patient notes.

    <p>syringe driver</p> Signup and view all the answers

    Which of the following best describes an unexpected death?

    <p>Not related to any prior illness or condition</p> Signup and view all the answers

    What should you do if you are unsure whether a death is expected?

    <p>Contact MPS</p> Signup and view all the answers

    It is permissible to move deceased persons from the scene if they are in a public place.

    <p>False</p> Signup and view all the answers

    What should families be advised to do regarding contacting their GP after a death?

    <p>Contact the GP on the next working day.</p> Signup and view all the answers

    For unexpected death, you should call _____ and convey to ED.

    <p>MPS</p> Signup and view all the answers

    Match the following procedures to the type of death:

    <p>Expected Death = Contact specialist team &amp; adhere to care plan Unexpected Death = Call MPS &amp; convey to ED Death of a Child in Community = Inform Emergency Bed Service Do Not Move Deceased = Seek advice from CHUB if police ask</p> Signup and view all the answers

    What should you NOT do regarding devices when verifying a death?

    <p>Remove devices</p> Signup and view all the answers

    The Emergency Bed Service must be informed for every verified child death.

    <p>True</p> Signup and view all the answers

    What does MCCD stand for?

    <p>Medical Certificate of Cause of Death</p> Signup and view all the answers

    Which of the following is a valid criterion indicating that resuscitation may be inappropriate?

    <p>DNACPR is in place</p> Signup and view all the answers

    Verification of death can be completed if a patient has been submerged for longer than 90 minutes.

    <p>True</p> Signup and view all the answers

    What is the legal process to register a death called?

    <p>Registration</p> Signup and view all the answers

    If more than _____ minutes have elapsed since the onset of cardiac arrest, there is no realistic chance that CPR would be successful.

    <p>15</p> Signup and view all the answers

    Match the following processes with their meanings:

    <p>Clinical confirmation of death = Clinically confirming that death has occurred Certification of death = Identifying the cause of death Registration = Legal process to record the death Verification of death = Assessment to determine if CPR is appropriate</p> Signup and view all the answers

    Which of the following is true regarding the documentation of deaths?

    <p>Findings and decisions must be recorded on the Patient Report Form.</p> Signup and view all the answers

    Temperature is a definitive diagnostic criterion for determining death.

    <p>False</p> Signup and view all the answers

    What must be documented in the additional information box when using an old LA3 form?

    <p>Areas of updated practice, such as 30 minutes ALS.</p> Signup and view all the answers

    In cases of unexpected death in patients, a __________ referral must be made.

    <p>safeguarding</p> Signup and view all the answers

    Match the following sections with their respective focus:

    <p>Section A = Criteria for death verification Section B = Documentation requirements Section C = Management of bodies Section D = Safeguarding procedures</p> Signup and view all the answers

    What should families do on the next working day after a death has been verified?

    <p>Contact the funeral directors of choice</p> Signup and view all the answers

    It is acceptable to move deceased persons from a public place without seeking advice.

    <p>False</p> Signup and view all the answers

    What does MCCD stand for?

    <p>Medical Certificate of Cause of Death</p> Signup and view all the answers

    What is a common drug used in End of Life Care (EoLC)?

    <p>Morphine</p> Signup and view all the answers

    For an unexpected death, you should call _____ and convey to ED.

    <p>MPS</p> Signup and view all the answers

    Pupils fixed and dilated are not important in the verification of death.

    <p>False</p> Signup and view all the answers

    Match the following actions with their corresponding situations:

    <p>Contact MPS = Unexpected death Leave LA3 with deceased = Expected death Advise family on contacting GP = After death verification Provide bereavement information = Family support needs</p> Signup and view all the answers

    Name one element that is essential for the verification of death.

    <p>No pulse</p> Signup and view all the answers

    What should you do if a responsible adult is not available after a death?

    <p>Contact MPS if death is expected</p> Signup and view all the answers

    A death that is anticipated due to an advanced, progressive disease is known as __________ death.

    <p>expected</p> Signup and view all the answers

    Match the drugs commonly used in EoLC with their purposes:

    <p>Midazolam = Sedation Ondansetron = Nausea control Haloperidol = Antipsychotic Hyoscine = Reduce secretions</p> Signup and view all the answers

    The Emergency Bed Service must be informed for every verified child death.

    <p>True</p> Signup and view all the answers

    If unsure whether a death is expected, you should check with _____ or HCP.

    <p>UCP</p> Signup and view all the answers

    Which of the following is a sign of unexpected death?

    <p>Severe trauma</p> Signup and view all the answers

    Rigor mortis must be present to verify death.

    <p>False</p> Signup and view all the answers

    What should be documented on the EPCR when deciding not to attempt resuscitation?

    <p>Sufficient evidence</p> Signup and view all the answers

    A death that is suspicious or not related to a period of illness is categorized as __________ death.

    <p>unexpected</p> Signup and view all the answers

    If you are unsure whether a death is expected or not, what should you do?

    <p>Seek advice if needed</p> Signup and view all the answers

    What should be done if there is a suspected drug overdose?

    <p>Transport the patient to the nearest A&amp;E with ongoing resuscitation</p> Signup and view all the answers

    CPR should be paused for a 30 second asystole check under all circumstances.

    <p>False</p> Signup and view all the answers

    Name one sign unequivocally associated with death.

    <p>Any of the following: Decapitation, Rigor mortis, Decomposition.</p> Signup and view all the answers

    Resuscitation should not be attempted if there is a valid _____ to Refuse Treatment (ADRT).

    <p>Advance Decision</p> Signup and view all the answers

    Match the following conditions with their descriptions for when verification of death should not be completed:

    <p>Pregnancy = Verification cannot occur due to the potential for recovery. Hypothermia = Verification cannot occur when it is the primary cause of death. Suspected drug overdose = Verification cannot be determined without thorough evaluation.</p> Signup and view all the answers

    Which of the following is a condition that indicates resuscitation should not continue?

    <p>A DNACPR decision is present</p> Signup and view all the answers

    Rigor mortis must be absent in all cases of verification of death.

    <p>False</p> Signup and view all the answers

    List one condition that would signify resuscitation should not be attempted.

    <p>The presence of a DNACPR decision.</p> Signup and view all the answers

    What percentage of hospital attendances are medication-related?

    <p>5-10%</p> Signup and view all the answers

    The national ‘Green Medicines Bag’ system was designed to improve medication management during hospital admissions.

    <p>True</p> Signup and view all the answers

    What is the main purpose of bringing patients' own medications to the hospital?

    <p>To perform a reconciliation process with GP records.</p> Signup and view all the answers

    Around £________ million is wasted each year on medications in the NHS.

    <p>300</p> Signup and view all the answers

    Match the following medication-related issues with their statistics:

    <p>Medication-related hospital attendances = 5-10% Avoidable medication-related attendances = 66% Annual NHS expenditure on medicines = £16 billion Annual waste on medicines = £300 million</p> Signup and view all the answers

    What is a common reason for calling a medical team regarding a catheter issue?

    <p>Blocked catheter</p> Signup and view all the answers

    It's acceptable for the catheter bag to be placed higher than the patient.

    <p>False</p> Signup and view all the answers

    Which site is safe for IV cannulation in adults?

    <p>Anterior aspect of the thigh</p> Signup and view all the answers

    What should be done if a catheter becomes painful or infected?

    <p>Replace the catheter immediately</p> Signup and view all the answers

    The medical professional escort is responsible for troubleshooting any alarms or error messages on medical devices.

    <p>True</p> Signup and view all the answers

    If the catheter drainage system becomes blocked, it is essential to check for _____ in the catheter tube.

    <p>blood or debris</p> Signup and view all the answers

    What stage of care is characterized by the delivery of medications when a patient is too weak to take them?

    <p>Palliative care stage</p> Signup and view all the answers

    Match the following catheter issues with their recommended actions:

    <p>Blocked catheter = Transport for review in A&amp;E Catheter leaking = Use incontinence pads Catheter pulled out = Replace immediately Difficulty swallowing = Consider syringe drivers</p> Signup and view all the answers

    The IV cannulation site on the anterior aspect of the _____ is at risk of being pulled out.

    <p>upper arm</p> Signup and view all the answers

    Match the following medical device components with their associated concerns:

    <p>IV Cannulation = Risk of being pulled out Medical Alarms = Error messages display Palliative Care = Delivery of medications Escorting Professional = Troubleshooting alarms</p> Signup and view all the answers

    What is a key consideration when transporting a patient with a catheter?

    <p>Manage patient’s pain</p> Signup and view all the answers

    Incontinence pads should be used to manage leakage from a catheter.

    <p>True</p> Signup and view all the answers

    What should healthcare providers don to prevent exposure to bodily fluids during catheter management?

    <p>Personal Protective Equipment (PPE)</p> Signup and view all the answers

    What is a primary purpose of ensuring all healthcare providers use the medication system?

    <p>To ensure timely medication administration</p> Signup and view all the answers

    The Green Bag must have the patient's name, date of birth, and incident number written on the inside.

    <p>False</p> Signup and view all the answers

    What device is primarily used to administer drugs and fluids intravenously?

    <p>Intravenous (IV) access</p> Signup and view all the answers

    A urinary catheter is used to drain the _____ when individuals have difficulty urinating naturally.

    <p>bladder</p> Signup and view all the answers

    Match the medical devices with their purposes:

    <p>Intravenous Access = Administer drugs and fluids Urinary Catheter = Drain the bladder Green Bag = Transport medications and belongings SMARTsafe = Secure personal items of patients</p> Signup and view all the answers

    What action should be taken if visible hemorrhage occurs at the IV access site?

    <p>Apply sterile gauze and gentle pressure</p> Signup and view all the answers

    Catheterisation is only used for patients who can urinate naturally.

    <p>False</p> Signup and view all the answers

    What must be applied at the IV access site if the patient is on coagulation therapy and bleeding occurs?

    <p>Extended pressure</p> Signup and view all the answers

    Which of the following is a common reason for using a urinary catheter?

    <p>Bladder weakness</p> Signup and view all the answers

    Indwelling catheters are designed to be inserted into the bladder temporarily.

    <p>False</p> Signup and view all the answers

    What type of catheter is inserted through the abdomen directly into the bladder?

    <p>Suprapubic catheter</p> Signup and view all the answers

    Patients may require a urinary catheter due to __________ caused by prostate enlargement.

    <p>obstruction</p> Signup and view all the answers

    Match the type of urinary catheter with its description:

    <p>Intermittent catheter = Temporarily inserted into the bladder Indwelling catheter = Remains in place for long periods Suprapubic catheter = Inserted through the abdomen Drainage bag = Collects urine from catheter</p> Signup and view all the answers

    What is a potential complication associated with an indwelling catheter?

    <p>Device leaking</p> Signup and view all the answers

    A urinary catheter can help deliver chemotherapy for bladder cancer.

    <p>True</p> Signup and view all the answers

    List one type of urinary catheter that is usually changed every 4 to 8 weeks.

    <p>Suprapubic catheter</p> Signup and view all the answers

    Study Notes

    Verification of Death Processes

    • Clinical confirmation involves determining that death has occurred.
    • Certification entails establishing the cause of death.
    • Registration is the legal process for documenting the death.

    Situations for Non-Resuscitation

    • In cases of terminal illness where death is expected, resuscitation attempts may be inappropriate.
    • Circumstances like submersion for over 90 minutes or clear clinical signs of death warrant no resuscitation.

    Criteria for Inappropriate CPR

    • More than 15 minutes have passed since cardiac arrest onset.
    • No evidence of CPR in the 15 minutes prior to ambulance arrival.
    • Asystole lasting over 30 seconds on an ECG monitor.
    • Absence of exclusion factors such as drowning or pregnancy.

    Verification of Death Exceptions

    • Verification cannot be completed in cases of pregnancy, severe hypothermia, or suspected drug overdose.
    • Such patients must be transported to an A&E for ongoing resuscitation unless transport is deemed futile.

    Signs of Death

    • Indicators unequivocally associated with death include:
      • Massive cranial or cerebral destruction.
      • Hemicorporectomy.
      • Obvious decomposition or putrefaction.
      • Presence of rigor mortis or hypostasis.

    Decision-Making for Adults' Resuscitation

    • Presence of DNACPR (Do Not Attempt CPR) or ReSPECT forms specifies that resuscitation should not be performed.
    • Advanced Decisions to Refuse Treatment (ADRT) must be respected, especially when involving a Lasting Power of Attorney (LPA).

    Expected Death from Terminal Illness

    • Documentation on Electronic Patient Care Record (EPCR) is necessary to support non-resuscitation decisions.
    • Evidence such as syringe drivers or hospice involvement is essential.

    Five Elements to Verification of Death

    • The verified death criteria include:
      • No pulse.
      • No respiration.
      • Absence of heart sounds.
      • Fixed and dilated pupils.
      • Asystolic rhythm on ECG for over 30 seconds.

    Management of Death

    • Expected Death: Acknowledged due to the natural progression of a terminal condition. Family should be advised to contact funeral directors and GP for MCCD (Medical Certificate of Cause of Death).
    • Unexpected Death: Requires immediate transport to coroner/investigation. Do not move or remove devices from the deceased.

    Important Considerations

    • Never move a deceased person from the scene, especially in public spaces.
    • Additional clarity can be sought from healthcare professionals, especially in complex situations.

    Procedures for Child Death in the Community

    • Inform Emergency Bed Service (EBS) if a child is verified deceased; EBS handles child death notification and safeguarding.
    • Ensure meticulous documentation of all actions and findings on the Patient Report Form.

    Updates on Resuscitation Guidelines

    • New LA3 forms are being distributed reflecting updated resuscitation practices and protocols.
    • Temperature as an indicator of death is not definitive; verification must meet specified criteria.

    Verification of Death Processes

    • Clinical confirmation involves determining that death has occurred.
    • Certification entails establishing the cause of death.
    • Registration is the legal process for documenting the death.

    Situations for Non-Resuscitation

    • In cases of terminal illness where death is expected, resuscitation attempts may be inappropriate.
    • Circumstances like submersion for over 90 minutes or clear clinical signs of death warrant no resuscitation.

    Criteria for Inappropriate CPR

    • More than 15 minutes have passed since cardiac arrest onset.
    • No evidence of CPR in the 15 minutes prior to ambulance arrival.
    • Asystole lasting over 30 seconds on an ECG monitor.
    • Absence of exclusion factors such as drowning or pregnancy.

    Verification of Death Exceptions

    • Verification cannot be completed in cases of pregnancy, severe hypothermia, or suspected drug overdose.
    • Such patients must be transported to an A&E for ongoing resuscitation unless transport is deemed futile.

    Signs of Death

    • Indicators unequivocally associated with death include:
      • Massive cranial or cerebral destruction.
      • Hemicorporectomy.
      • Obvious decomposition or putrefaction.
      • Presence of rigor mortis or hypostasis.

    Decision-Making for Adults' Resuscitation

    • Presence of DNACPR (Do Not Attempt CPR) or ReSPECT forms specifies that resuscitation should not be performed.
    • Advanced Decisions to Refuse Treatment (ADRT) must be respected, especially when involving a Lasting Power of Attorney (LPA).

    Expected Death from Terminal Illness

    • Documentation on Electronic Patient Care Record (EPCR) is necessary to support non-resuscitation decisions.
    • Evidence such as syringe drivers or hospice involvement is essential.

    Five Elements to Verification of Death

    • The verified death criteria include:
      • No pulse.
      • No respiration.
      • Absence of heart sounds.
      • Fixed and dilated pupils.
      • Asystolic rhythm on ECG for over 30 seconds.

    Management of Death

    • Expected Death: Acknowledged due to the natural progression of a terminal condition. Family should be advised to contact funeral directors and GP for MCCD (Medical Certificate of Cause of Death).
    • Unexpected Death: Requires immediate transport to coroner/investigation. Do not move or remove devices from the deceased.

    Important Considerations

    • Never move a deceased person from the scene, especially in public spaces.
    • Additional clarity can be sought from healthcare professionals, especially in complex situations.

    Procedures for Child Death in the Community

    • Inform Emergency Bed Service (EBS) if a child is verified deceased; EBS handles child death notification and safeguarding.
    • Ensure meticulous documentation of all actions and findings on the Patient Report Form.

    Updates on Resuscitation Guidelines

    • New LA3 forms are being distributed reflecting updated resuscitation practices and protocols.
    • Temperature as an indicator of death is not definitive; verification must meet specified criteria.

    Catheter Management

    • Leakage may indicate a blockage in the catheter, making it essential to monitor drainage.
    • Blood or debris can accumulate in indwelling catheters; a blockage may occur if not managed.
    • Common issues prompting calls include blocked catheters, removal incidents, leakage, and issues beyond community team capabilities.

    Emergency Procedure for Catheters

    • Immediate catheter replacement is necessary if clogged, painful, infected, damaged, or leaking.
    • If the care provider cannot resolve the issue, transport patients to Accident & Emergency (A&E).
    • Use personal protective equipment (PPE) to prevent exposure to bodily fluids during transport.
    • Incontinence pads can absorb any escaping fluids, and patient comfort and pain management should be prioritized.

    Transport Considerations

    • Keep the catheter bag lower than the patient to facilitate drainage.
    • Avoid kinking the catheter tube which could lead to further blockages.
    • Handle the catheter carefully to prevent it from being pulled out.

    Syringe Drivers and Medication Conveyance

    • Syringe drivers are essential for patients who feel sick, have swallowing difficulties, or require medication during transport.
    • Medication-related hospital attendances account for 5-10% of total visits, with 66% deemed avoidable.
    • The NHS allocates around £16 billion annually to medications, with £300 million wasted.

    Importance of Patient Medication

    • Patients should always transport their own medications for effective reconciliation against GP records upon admission.
    • A national ‘Green Medicines Bag’ standardizes medication conveyance, ensuring accurate administration and reducing medication waste.
    • The Green Bag must include the patient’s name, date of birth, and incident number on the outside.

    Intravenous (IV) Access

    • IV access allows drug and fluid administration; patients should be positioned securely during transport.
    • Immediate care for visible bleeding at the IV site includes applying sterile gauze and gentle pressure until bleeding stops.

    Catheterization Purposes and Types

    • Urinary catheters are utilized for urinary incontinence, retention, post-surgical needs, or other medical conditions.
    • Intermittent catheters are temporary, inserted, and removed after draining the bladder.
    • Indwelling catheters remain inserted for long periods, held by a balloon, with a drainage bag for urine collection.

    Reasons and Complications of Catheter Use

    • Indications for catheters include urethral blockage, bladder weakness, surgical needs, and palliative care.
    • Common complications consist of bleeding, leakage, device damage, and blockage.
    • Leakage can also arise from indwelling catheters, and medications may not be well-tolerated by some patients.

    Location Sites for IV Access

    • Common IV sites include the anterior aspect of the upper arm, anterior thigh, and abdominal wall.
    • Proper location selection is crucial to minimize risk of the device being pulled out.

    Handling Alarms and Error Messages

    • Medical professionals are responsible for addressing alarms and error messages on devices during patient transportation.

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    Related Documents

    London Ambulance Service Verification of Death PDF
    L3 Conveyance of patients with own meds and medical devices v1 September 2020 PDF

    Description

    This quiz covers the critical processes involved in verifying death, including the steps for clinical confirmation, certification, and registration. It also discusses the situations where non-resuscitation is appropriate, as well as the criteria for inappropriateness of CPR. Gain a comprehensive understanding of these vital medical protocols.

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