What are your basic procedures post-mortum?

Havin' A Party!, ASN, RN · Jan 19, 2004

Well understood, Florry.

Thank you.

(Your English is only about a million times better than my Norwegian.)

florry · Jan 19, 2004

Yes, I can really imagine that whitout NO DOUBT!!!!

selfironicc 'Florry

happystudent, RN · Jan 20, 2004

Interesting thread...

In the Emergency Dept. when there is a death, the techs usually perform post mortem care. After the the person is pronounced, we tie off all peripheral lines, iv's central, etc.. We cut the Et tube and secure it in the mouth. If it is a bad trauma with excessive blood, broken bones, head trauma , we clean the body as best as we can and the docs will usually staple shut any lacs to prevent more fluid loss.

Sometimes,We dont have alot of time to prep the body because the families are usually there and want to see their loved one. So we do the best we can, making the person presentable.

We dont take out anything that was used in the code. It can be VERY messy, fluids everywhere, but we deal with it as respectively as possible.

Its hard, tho. In any moment we will have a trauma and the person doesn't make it, I feel sad sometimes because we are usually the last people to see this persons heart beat for the very last time.....

sigh....

The one thing that really bothers me is that when it is time to bring the body to the morgue, we have to push the stretcher with a sheet on top all the way through the ED.

Thats not cool, but its the only way to get to the morgue...

Wolfpax · Jan 20, 2004

Basically when I worked the ER the idea was to be sure to dress the patient, slip them in a wheelchair and take them to either the hospital cafeteria or coffee shop, if closed then the bus stop outside the ER would suffice, the object was to make it appear that they had not been through the ER yet... if an ambulance was available we would transport them to the competition's ER...

When I first started in patient care, many moons ago, I was an EMT in the ER, my first time to the morgue was with a person we had coded for what seemed like forever and I took her down to the basement, through the back hallways away form other units or visitors, I pushed the stretcher in the elevator, hit the basement button and as the doors finshed closing...(I was standing with my back to the stretcher)... she let out her last breath which turned out to have a very loud groan that went along with it...(no one warned me about last breaths)... for weeks after that I would put the stretcher in the elevator, hit the basement button and then take the stairs to meet the body at the elevator door.

suzanne4, RN · Jan 20, 2004

You answered exactly right. When you die you lose all sphincter control so that is the reason for the Depends or a stack of blue chux. Also, I remember when we used to have codes in the Emergency Dept., one group was working on the patient and another person was getting a foley in as quickly as possible. Same reason..................................

NeuroICURN · Jan 20, 2004

In our hospital, if a pt has passed away, we do the following:

If it isn't a coroners case, we remove all lines, foleys, etc.

Then, usually we try to make sure the person is clean before death, but if they weren't, then we try to clean them up afterward. However, we don't do any of the tampons, or pads that you all do. This is actually the first time I've heard of it!

Then we tag and shroud them.

Now here's the tricky part. Our particular ICU has beds on 2 floors. If the person dies on the 3rd floor, then we simply wheel them out to the elevators and down to the morgue. Now if they die while on 9, then you have to walk past pt's rooms and our ICU waiting room to get to the elevators. In that case, we ask all the visitors to go to a different waiting room (that's out of sight), then we close all the pt's doors.

In the hospital where I did clinicals, it was nice because they had a cart that you couldn't even tell you had a body on. It had a "table top", so it looked like you were just pushing an empty cart.

Now, how many of you have had people that wouldn't fit in the freezer either? I ended up having to put them in the autopsy room! Ugh!

Take care everyone.

:kiss

florry · Jan 20, 2004

Dear Happystudent!

You deal with a very important side abaut taking care of the dead person: As hospital employed we will always get a reaction; somtimes we are sad, sometimes relieved (because the pt didnt suffer anymore). And all emotiions are very important to talk about with collegues or a superviser! All emotions are normal and allowed. And if we are continung playing "hard" and this is business, we will meet the wall sometimes.

The last years they are beeing focuses on healthcare proff. emotions: catastrophic psychiatry is one of the field witch is research. I now know they are focusing in debriefing, not for reporting "people", but for learing and sharing emotions. Spec. in ER you will meet death in a spec. way; often changed look, hard injuries and so on.

Also if you work in LTC or hospice, people dies, they get palliativ and very important care, but they will die. Take care of the wardpersonell who are working with death, dying , trauma all supervisers around the world!

If you cant talk this true with another professional, I will say its "obs a warning for post traumatic stress syndrom".

Thank you everyone for a very interesting thread!

From Florry

suzanne4, RN · Jan 20, 2004

Over here in Thailand, things are done quite differently. 95% of the population is Buddhist. Once deceased, the patient is immediately taken down to the "post" room at the hopsital. The family is able to see the patient at that time if they desire. Then they are immediately embalmed at the hospital before being sent to one of the many temples. Average memorial service goes on for about one week, every evening. Shortest time that I have noticed is 3 days. The cremation ceremony follows which all of the relatives and family actually view, quite different from the US.

Ashes are given to the family, usually the next day or so.

Some of the larger temples can actually handle 40 deceased people at the same time. They are each placed in an individual room in a white casket that has gold painting all over. Friends and relatives send wreaths that are displayed near the coffin. Just before the cremation service the casket is placed on a special "chariot" and taken around the crematorium 3 times, because of the distance they had to travel in the old days. If the family is Chinese, then cardboard replicas of a house is in the room, anything that the person would need in his next life to be comfortable. There may be a 747 plane, a Mercedes, a microwave, a stove, furniture, all done in cardboard and painted. The night before the cremation thses objects are also cremated so that they will be waiting for the person at their next level.