From medical student to junior doctor: care of the deceased patient
In the fifth article of our series, Richard Beasley and colleagues explain why the death of a patient should not be considered the point of cessation of care and describe what you should be aware of after your patient dies
- By: Sarah Aldington, Geoffrey Robinson, Richard Beasley
By necessity, medical training focuses on caring for living patients, which leaves some junior doctors unsure of what to do when a patient dies. Far from being the end of the job, there is a considerable amount of work to be done when a patient dies and often difficult decisions still need to be made.
The first thing to be done when a patient dies is to confirm death. Although this is one of the easiest diagnoses to make in medicine, the process should not be treated with complacency.1 The absence of a pulse or respiration at a specific point is not always consistent with death. Profound hypotension can result in the loss of a radial pulse, and conditions such a hypothyroidism and hypothermia can slow the pulse rate considerably. Cheyne-Stokes breathing (alternating periods of apnoea and hyper-apnoea) is commonly seen in the preterminal phase (the period shortly before death)