Advances in medical technology together with new legislation, have vastly complicated the process of confirming death1. The Academy of Royal Medical Colleges(ARMC) have produced a code for the diagnosis and confirmation of death to address this1.
Using this code as a standard, we report the results of an audit assessing clinician confirmation and documentation of death.
Retrospective study of 45 sets of patient case notes was performed in our Neurosurgical Intensive Care(n = 15), General Intensive Care(n = 15)and the Accident and Emergency(n = 15) units. A further 8 case notes of patients that went on to organ donation after cardiac death were also assessed.
Only the 8 cases that went forward for organ donation were documented as per ARMC guidelines. No other cases met the audit standards. This was true over the full range of clinician grades.
The accurate certification of death is important because: it avoids a delay in releasing the deceased's body for burial; it provides some defence in the (rare) incident of the ‘Lazarus phenomenon’ (return of spontaneous circulation after cessation of cardio-pulmonary resuscitation); and finally because it represents the last duty of the clinician for their patient.
On the basis of this audit, we have conducted an educational campaign and introduced a proforma for the confirmation of death in our institution. We are repeating our audit to assess the impact of these interventions.
A Code of Practice for the Diagnosis and Confirmation of Death, Academy of Medical Royal Colleges, 2008 http://aomrc.org.uk/publications/reports-guidance.html (Accessed October 2011).
© 2012 European Society of Anaesthesiology