Death in Village
Pronouncing a patient dead in the village can be a challenge. It is simple if there is evidence of trauma that is not compatible with life or rigor mortis has set in. Unwitnessed events can be trickier. Always have the CHAs check a pulse for a long time and in more than one place. If a patient is found apneic and pulseless without a witness, CPR should be initiated, but stopped if there has been adequate CPR and resuscitation without response. If a patient is found hypothermic, CPR needs to be initiated and the patient’s core temperature brought up to >90 degrees before a patient can be pronounced dead. A patient is not considered dead until they are “warm and dead.”
For any death in the village there must be --
1. A free text /message encounter death note in RAVEN (using the fin number for that event encounter). This encounter should document the circumstances of the death and that all the required documentation and communication has occurred.
2. A death packet needs to be completed (these are located at NW or ER Nursing station and should be in each of the village clinics (see Death Packet forms links below). This packet includes a notification of death, information for notifying Life Alaska (Stat line (888)543-3287) and the Donor Protocol, a Transit Burial Permit (usually done by Alaska State Troopers in the village), Certificate of Death, Post Mortem Exam Release if needed and a packet of information for families about burial etc.
3. A copy of the death note/message and the completed Certificate of death should be forwarded to Rebecca Tunuchuk (medical records technician) or YKHC Health Information Management with a cc to Chief of Staff. Please make a note about whether you will be signing the death certificate or not.
An expected death should have had an expected death form completed and faxed to the Bethel Police Department and the Troopers office. If the VPO and Troopers have access to this form, they can release the body to the family without further investigation unless there are other suspicious circumstances.
Expected Home Death (Links to pdf form for printing)
1. The CHA will call the Village Police Officer (VPO).
2. The provider pronouncing the patient dead will need to speak with Alaska State Troopers (AST) at 907-543-2294 AND Medical Examiner (ME) at 888-332-3273 to notify them of an unexpected death and give them more information regarding the medical issues past and present.
3. VPO/Troopers will maintain custody of the body until they and the ME make a decision whether to release the body to the family or bring the body to anchorage for an autopsy.
4. You will not be responsible for signing the death certificate of any patient that is an ME case.
Other Forms (Death Packet)
Links to pdf