Remove Foley catheter and IV when resident dies?

[Ash0315]

If you have a patient that is on hospice crisis care and they pass, do you remove the Foley and IV before calling mourge??

also so what steps does your facility take after someone dies?

[AnnieOaklyRN, BSN, RN, EMT-P]

Since hospice patients are under medical care with a diagnosis that is expected to be fatal in 6 months or less, an autopsy will not be performed. (There could be cases where there has been an exception, I have never heard of one, but there could be. If anyone knows of such a case, I'd be super interested in hearing about it.)

So yes, removing devices is part of normal post-mortem care, and we would do this, give bed bath, change linens, redress and make sure the body is in a natural (and flat) position before rigor mortis sets in. We would normally allow family a few minutes before the care, if they are already present. And definitely some time after the care is done before we call the funeral home to come and collect the body.

You have to call the Medical examiner for EVERY death, it doesn't matter what they died from or whether or not they were in hospice!

Annie

[verene, MSN]

You have to call the Medical examiner for EVERY death, it doesn't matter what they died from or whether or not they were in hospice!

Annie

Perhaps this depends on locality? My understanding (and I could be wrong since I wasn't the one who had to make the phone calls) was that in our county if a patient died on hospice care and there was no reason to require autopsy (e.g. recent fall, suspected or known abuse/neglect, etc) the M.E. was not directly involved.

We did have to notify the county of the death for the purposes of having a death certificate printed, but the vast majority of decedents were released directly to their chosen funeral homes and not to the county morgue.

Provided the patient did not require autopsy we as hospice personnel could preform all necessary post-mortem care - including removal of lines/catheters, washing, and dressing - and release directly to funeral home for memorial preparations.

[kcochrane]

Perhaps this depends on locality? My understanding (and I could be wrong since I wasn't the one who had to make the phone calls) was that in our county if a patient died on hospice care and there was no reason to require autopsy (e.g. recent fall, suspected or known abuse/neglect, etc) the M.E. was not directly involved.

We did have to notify the county of the death for the purposes of having a death certificate printed, but the vast majority of decedents were released directly to their chosen funeral homes and not to the county morgue.

Provided the patient did not require autopsy we as hospice personnel could preform all necessary post-mortem care - including removal of lines/catheters, washing, and dressing - and release directly to funeral home for memorial preparations.

I think it does. At the nursing homes here we don't call the ME except in certain circumstance. Within a matter of hours all resident are sent to a funeral home. When I worked at the hospital, the MD also had criteria set up in advance to determine if the ME was called.

[Mavrick, BSN, RN]

In the hospital where I work we call ALL deaths first to organ procurement then Medical examiner to get releases. Then and only then prepare for family. As above, take out tubes, clean, replace dentures, gather belongings, reposition, etc. In my experience I have found IV's, especially central lines can bleed a LONG time. It seems like forever when the family is waiting. I always have chairs and a couple boxes of tissues available for grieving family members.

[HeySis, BSN, RN]

You have to call the Medical examiner for EVERY death, it doesn't matter what they died from or whether or not they were in hospice!

Annie

That must vary from state to state. I have worked hospice and LTC for many years and never once had to call a ME. In my state as long as the person was under medical care, (which they always were in the cases I had) we notified the family, the attending physician and then the funeral home. The funeral home cam and picked up the body.

[Wuzzie]

Granted I worked in an ED but in my state if a nurse put it in it could be taken out. This would include Foley catheters, IVs and usually ng/og tubes that had been used only for gastric decompression. Adjunct airways, chest tubes and any type of central or arterial line had to stay until cleared with the coroner.

[compassionresearcher]

The rabbi at a hospital where I worked in New York City told us to not remove any equipment on Jewish patients until a religious representative has come to approve it. There are some things the family may wish to bury with the patient, or there is a particular way they are removed/disposed of. I am not claiming to be an expert in the matter, that is just what we were told.

[Penelope_Pitstop, BSN, RN]

You have to call the Medical examiner for EVERY death, it doesn't matter what they died from or whether or not they were in hospice!

We had to do that also, but the ME office made its decision very quickly typically. I would call the office as part of our "death checklist" and received my answer almost immediately. But, in the hospital, I always worked on medical floors. The deaths were either expected or not shocking. If you're working in a department that involves a lot of "unnatural" deaths (For lack of a better word), then I imagine you probably will be able to assume which are ME cases before the call is even made. I think the ED is probably the most common place for ME-appropriate cases.