PROCEDURE FOR CARE OF BODY AFTER DEATH

PURPOSE: To care for the body after death and comfort the family.

KEYPOINTS:

1. Pronouncement of death is done only by a physician who is responsible for notifying 1) the family, 2) Pulaski County Coroner if a violent or unusual death 3) obtaining the autopsy permit.
2. ARORA contact may be made by the Physician or nurse.  No one except ARORA is to approach the patient/family about organ donation.  UAMS Chaplains may approach families about tissue and eye donation only.
3. Nursing staff will notify nursing supervisor.
4. Quiet rooms are available for family use. The keys to these areas may be obtained from the Nursing Supervisor or Chaplain. The chapel on first floor (Ward Bed Tower) is also available.
5. Reporting environment risk - Red toe tags must be used on all patients posing an environment risk. Tag must state reason for precautions (ex.: blood and body fluid precautions, chemotherapy, radioactive material, respiratory infections or wound infections).

EQUIPMENT:

1. Necessities for bathing body, removing tubes, and IV's.
2. Clean linen, if necessary.
3. Forms:

Death Certificate

Anatomical gift paperwork if appropriate

Toe Tag (1)

Report of Death in electronic medical record (EMR) or MR # 401 in ED or during downtime or EMR

Morgue Identification Tag

Autopsy Status Form (MR #39)

Red toe tag (if needed)

Morgue Log Form

4. Conceal-a-cart (8^th Floor).
5. Appropriate size Cadaver Bag

PROCEDURE STEPS:

When vital signs have ceased, notify physician.

KEYPOINT: Comfort family as needed.

1. Prepare body and remove equipment, if approved by the coroner.

KEYPOINT: In Coroner’s cases, tubes are left in, but clamped. IVs are left in and clamped, or tied in knot. E.T. and N.G. tubes are left in place and plugged. Do not bathe victims of gunshot wounds or remove brown paper bags from hands/feet if present. Proper identification must be assured.

a. Confer with family regarding special care requirements.
b. Replace all prosthetic devices.
c. Remove tube, catheter, IVs, and change dressing (s), if necessary.
d. Bathe body.
e. Remove equipment from room as indicated.
f. Permit family to spend time with patient, if they wish.
g. Attach ID Tags to toe and arm, unless armband is left on and legible. If needed, attach red toe tag.
h. Place body in appropriate sized cadaver bags (adult, XL-Adult, or Infant)

1. Place cadaver bag on bed & unzip; log roll patient
2. Grasp Zipper & pull toward the edge under the patient
3. Do NOT have any linen (gown or sheets within the bag)
4. Attach ID Tag to toe. Make sure legible armband is on patient
5. Slide patient over to Morgue Cart
6. Place shroud cover over Morgue Cart
7. Take patient to Morgue with Morgue Identification Tag and Morgue Log  

i. Pack personal belongings and give to next of kin. Document on flow sheet.
j. Send personal belongings to Morgue if family is not present.
k. Ascertain the family’s choice of funeral home. If family is undecided, have them call the Morgue, or have funeral home call Morgue. Check that all forms have been completed and signed. (See list under equipment).

KEYPOINT: Authorization is required for an autopsy. For an Autopsy done in UAMS Morgue or Coroner's cases send a COPY of chart with body or mark the chart Coroners Case or Autopsy to be done and leave it on the unit.  The original chart is not to go to the morgue. 

4. Keep disassembled chart on floor to send to Medical Records.
5. Transport body using Conceal-A-Cart which is located on the 8^th floor.

REFERENCES:
Policies: L-1 Reporting Unusual Deaths and DOAs

RESOURCE PERSON(S):
Joyce Randof, RN, MNSc, BC,

 
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