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How To Recognize a Death has Occurred

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Updated: November 17, 2006

These signs of death are general guidelines for telling a death has occurred. Not all dying people go through each of the signs; some die quickly. The criteria used to pronounce a death is in parentheses.
Difficulty: N/A
Time Required: 5 minutes to read

Here's How:

  1. The dying person stops breathing.(No respirations)
  2. The chest may still rise as if to breathe, as muscle contractions occur in the chest.

  3. The heart may continue to beat a few minutes longer after breating stops.

  4. The dying person may have a brief seizure.

  5. The heart stops beating. The blood stops circulating. The person no longer has a pulse. (No heartbeat)

  6. The dying person cannot be woken up/awakened. (No response to stimulus)

  7. The skin color turns pale, bluish then a whitish or ashen grey as the blood settles.

    • The color changes can be most easily noticed on the dying person's lips, hands and feet.
  8. The dying person's body temperature drops as blood stops circulating. The skin and body becomes cold.

  9. Different muscles in the body relax causing different signs to occur.

    • The arms and legs become limp, as the person loses muscle tone.
    • The person's mouth may fall open when the jaw muscles relax.
    • The person's eyes remain open, as eyelid muscles can no longer close. The eyes remain in a fixed stare as muscles of the eye and the pupil no longer work.
  10. The sphincter muscles in the body (the special muscles that hold body organs closed)relax.

    • The bowel and the bladder relax.
    • Bowel and bladder contents (stool and urine) may be released.

Tips:

  1. Death is determined if there is no pupillary light reflex (pupils are fixed and dilated), no response to verbal or tactile stimulus (voice or touch) and there are no spontaneous respirations or no pulse or heart sounds (heartbeats).
  2. Sources:
    DeSpelder LA. Strickland AL. 2002. The Last Dance: Encountering Death and Dying. 6th Ed. N.Y., N.Y.: McGraw Hill.
    EPEC Project. 1999. Module 12: Last Hours of Living. EPEC Education for Physicians of End-of-Life Care. Princeton N.J.: The Robert Wood Johnson Foundation.

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