Last Offices

Question 1

What is the role of the mortuary in caring for a body after death?

Answer 1

• Receipt and temporary storage of bodies
• Investigations into the cause of death by carrying out a PM
• The demonstration of PM findings in cases of clinical interest or for teaching purposes
• The viewing of a body
• Identification of a body
• Accommodating visiting from relatives/ NOK

Question 2

What personal care needs to be performed after death?

Answer 2

• Needs to be carried out within 2-4hrs of a death, to preserve appearance and respect dignity
• Refrigeration is required within 4hrs of death as the body’s core temp will take time to lower
• PPE should be worn at all times
• Patient should be laid on back
• Patients to be wrapped in sheet that covers face and placed in body bag
• Eyes to be closed
• Hair to be tidy in preferred style
• Debris to be removed from mouth and dentures put in mouth as soon as possible after death
• Patients to be washed and dressed in own nightgown or shroud
• Check patient identity on ankle and wristbands
• Jewellery to be taped or given to family and documented on property form
• Use recommended hand hygiene techniques after attending patient and ensure the disposal of clinical waste and linen

Question 3

How may infection be spread after death?

Answer 3

• Intestinal pathogens from oral and anal orifices
• Through abrasions, wounds and sores on the skin
• Contaminated aerosols from body openings or wounds
• Splashes or aerosols on eyes

Question 4

How can infection be controlled after death?

Answer 4

• Ensure body bag and death notice are appropriately identified as risk of danger of infection
• Death notice must notify what the pathogen is e.g. Hep B, HIV, TB
• MRSA and C Difficile are not infectious after death

Question 5

What is required for the verification of a death?

Answer 5

• Pupils are fixed and not dilated
• No responses to painful stimuli
• No palpable carotid pulsations
• No heart beat or breath sounds heard over 1min
• Details documented in patients notes
• Patients identity must be confirmed
• Name, DOB, Address, NHS no should be checked
• Person who verifies death is responsible for attaching ankle and wristbands

Question 6

What general and legal requirements are there for deaths?

Answer 6

• Registration of death
• Authority for disposal
• Funeral arrangements
• Burial
• Cremation
• Disposal at sea
• Removal of bodies out UK

Question 7

When is a post mortem required?

Answer 7

• If it is an unexpected death
• If it is violent, unnatural or suspicious
• If it occurred during or soon after a hospital procedure
• If the cause of death is unknown