Death Exam and Pronouncement

• Familiarize yourself with the child's history before entering the room

• Consider asking the child's nurse or chaplain to come with you to introduce you to the family and provide additional support

• Turn pager and phones to silent or consider asking someone else to hold them

• Identify yourself, explain what you are doing

  • “My name is Dr. Snaman, the nurse called me to let me know that Johnny has stopped breathing. Would you mind if I did a brief exam?”

  • “It is so peaceful in here right now…”

• Identify patient

• Ensure no hypothermia

• Assure no arousal to verbal or tactile stimuli

• Listen for absence of heart sounds (~60 sec)

• Look and listen for respirations

• Note absence of pupillary reflex (not necessary)

• Note time (to self)

• Empathetically inform family – your child has died

  • “I am so sorry. Johnny has died.”

  • “Please feel free to stay with him as long as you would like. Is there anyone that I can call for you?”