death note

[frog1]

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Does anyone have a good sample death note to share? It has been a difficult task for me to come up with a death note that is complete and concise, professional looking with grace and style.
🙁

 

[Bobblehead]

The Washington Manual Intern Survival guide has an example I believe. I generally write something brief:

Called to see patient for unresponsiveness. On exam the patient did not respond to verbal or physical stimuli. Absent heart and breath sounds (modify if on vent to no spontaneous respirations). Absent peripheral pulses. Pupils are fixed and dilated. Patient pronounced dead at XX:XX (24 hour format). Dr. [Attending] notified. Next of kin/family (XXX) notified. Autopsy declined. Medical examiner Dr. XXXX declined examination (if appropriate and you were prompted by the hospital to call the ME) [Organ donation may be discussed if your state prompts you to do so, some places have separate services for this.]

I time/date all of my notes so I don't report date in the note itself but you may wish to do so.

 

[gutonc]

The Washington Manual Intern Survival guide has an example I believe. I generally write something brief:

Called to see patient for unresponsiveness. On exam the patient did not respond to verbal or physical stimuli. Absent heart and breath sounds (modify if on vent to no spontaneous respirations). Absent peripheral pulses. Pupils are fixed and dilated. Patient pronounced dead at XX:XX (24 hour format). Dr. [Attending] notified. Next of kin/family (XXX) notified. Autopsy declined. Medical examiner Dr. XXXX declined examination (if appropriate and you were prompted by the hospital to call the ME) [Organ donation may be discussed if your state prompts you to do so, some places have separate services for this.]

I time/date all of my notes so I don't report date in the note itself but you may wish to do so.

Yup, that seems about right for the death note. No need for it to be more extensive than this although if the pt is on tele, i'll put a flat-line strip at the end of my note. A code note that ends in death should be a usual code note w/ the outcome noted.

WRT cause of death and the like, that all goes on the death certificate, not in the death note and, if you're not the primary team you can/should punt that job.

If you're doing the post-death d/c summary a regular summary is appropriate as well.

 

[MedStudent2007]

yup, that's what i write too...

called to pronounce pt. dead
pt alone in room, unresponsive to physical or verbal stim.
no heart tones, no spon. respirations, pupils fixed and dilated
pt pronounced dead at - xx;xx
attending notified, family notified and on their way, etc. etc.
we fill out a death certificate which takes care of the ME stuff

 

[JayneCobb]

If you want to be technically correct, here's a brief one to include some key points required in the definition of death. (I modified Bobbleheads)


Called to see patient for unresponsiveness. On exam the patient did was unresponsive, no spontaneous movement was observed, pt did not respond to verbal or noxious stimuli. Absent heart and breath sounds for more than 1 minute. Pupils are fixed and dilated, corneal reflex was absent.

Patient pronounced dead at XX:XX (24 hour format). Dr. [Attending] notified. Next of kin/family (XXX) notified (or at bedside). Autopsy declined. Medical examiner Dr. XXXX declined examination (if appropriate and you were prompted by the hospital to call the ME)

It doesn't have to be a novel, 3 big things to hit on, not heart sounds for more than 1 minute, no response to noxious stimuli, and absent corneal reflex

 

[PeepshowJohnny]