Death, Dying, and Postmortem Care

life support

"A set of therapies that preserve the patient's life when body systems are not functioning sufficiently to sustain it."

Buddhism

a faith that believes in reincarnation, with the specifics determined by the last thoughts of the dying person

Catholicism

a faith that performs the ritual called Anointing of the Sick for the seriously ill

Hinduism

a faith where cremation is believed to be the best way for a spirit to begin its journey

Muslim

a faith where the dead must be turned to face Mecca, their holiest city

Jewish

a faith where the dead must not be left alone

90 minutes

a patient is a candidate for Donation after Cardiac Death (DCD) if it is predicted that the heart will cease functioning after _______ following removal from mechanical support

uniform anatomical gift act

act that constitutes a uniform donor card as a legal written consent

active euthanasia

actions that speed the process of dying, such as the administration of morphine; can be voluntary or involuntary

living will

allows a patient to state in writing exactly what medical interventions they are willing to endure to sustain life

do not resuscitate/do not intubate (DNR/DNI)

an order initiated by the patient that states that resuscitation should not be attempted if they suffer cardiac or respiratory arrest

organ procurement organization (OPO)

collects organs and tissues from donors, exchange organs geographically, and register patients in need of transplant

advanced directive

general term that refers to one of two documents used to speak for patients in the event they become incapacitated; living will or power of attorney

midline sternal-splitting incision

incision made to harvest organs

forensic evidence

information about the patient's condition, personal effects and attire, and materials discovered during the surgical procedure

power of attorney

legal way to appoint a health care proxy who will make medical decisions for the patient in the event that he or she cannot

drainage tubes, implants, catheters, medication vials, solution containers

may need to be left in place for removal and examination during autopsy

surgeon

notifies the family when a patient dies in surgery

whole-brain death

one of three acceptable stages of death; irreversible loss of all functions of entire brain; current law as to what defines death in legal courts of most countries; flat EEG, unresponsiveness, lack of pupillary reflexes, and decreasing body temp

cardiac death

one of three acceptable stages of death; irreversible loss of cardiac and respiratory function; permanent absence of heartbeat and respiration

higher-brain death

one of three acceptable stages of death; irreversible loss of higher-brain function; brain stem continues to provide respiration, blood pressure, and heartbeat without assistance

coroner

patients who die as a result of or in the commission of a crime become the property of the _____ (consent is not needed from the family at this point)

spiritual (religious) beliefs

plays an important role in end-of-life care and needs to be respected by all medical staff

coping strategies

realize that everyone involved is part of a team effort, believe in a power greater than the skills of the team, share feelings with others, identify personally with the loss, visit facility support group, visit hospital chaplain

newborn to 80

the age range of tissue donors

newborn to 65

the age range of vital organ donors

irreversible coma not caused by pharmacological agent, absence of spontaneous movement, no cranial nerve reflexes

the criteria for brain death, per B&K

denial, anger, bargaining, depression, acceptance

the five stages of grief, in the most common order (not everyone follows this order)

accidental, terminal, prolonged (chronic), sudden

the four general categories of death

right to refuse treatment

the legal right of patients to refuse certain forms of treatment; allowed by the AHA patient care partnership

immunologic rejection and infection

the two primary causes of transplant failure

cadavers and living related donors

the two primary sources of donor organs and tissues

1990

the year the Patient Self Determination Act was passed

extraordinary life support

therapies that may pose an undue burden on the patient and may be costly; a futile treatment

ordinary life support

therapy used to prolong life that the physician is morally obligated to provide without imposing an additional burden on the patient

skin, bone, heart valves, blood vessels, and corneas

tissues which can be recovered from a patient during organ procurement of a nonheartbeating donor

palliative treatment

treatment providing relief of symptoms, but not a cure

therapeutic treatment

treatment used to treat or manage a disease, including elective and non-elective surgeries

united network for organ sharing and euro transplant register

two organizations that maintain computer lists of patients waiting for donor organs

passive euthanasia

when the physician does nothin to preserve life