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Permanent cessation of all vital functions including those of the heart, lungs, and brain. SEE TABLE: The Leading Causes of Death in the U.S. (2010)*; SEE: brain death; SEE: euthanasia; SEE: life

The principal clinical signs of death are apnea and asystole. Other indications, including loss of cranial nerve reflexes and the cessation of the electrical activity of the brain, may be necessary for those receiving mechanical life support.

Legal procedures and institutional protocols should be followed in the determination of death. The times of cessation of breathing and heartbeat are documented, and the physician or other legally authorized health care professional is notified and asked to certify the patient’s death. The family is notified according to institutional policy, and emotional support is provided. Auxiliary equipment is removed, but the hospital identification bracelet is left in place. The body is cleansed, clean dressings are applied as necessary, and the rectum is packed with absorbent material to prevent drainage. The deceased is placed in a supine position with the limbs extended and the head slightly elevated. Dentures are inserted, if appropriate; the mouth and eyes are closed; and the body is covered to the chin with a sheet.

The deceased's belongings are collected and documented. Witnesses should be present, esp. if personal items have great sentimental or monetary value. The family is encouraged to visit, touch, and hold the patient's body as desired. In some situations (as in neonatal death or accidental death) and according to protocol, a photograph of the deceased is obtained to assist the family in grieving and remembering their loved one. A health care professional and a family member sign for and remove the patient's belongings.

After the family has gone, the body is prepared for the morgue. Body tags, imprinted with the patient's identification plate or card information (name, identification number, room and bed number, attending physician), along with the date and time of death, are tied to the patient's foot or wrist as well as to the outside of the shroud. The body is then transported to the morgue and placed in a refrigerated unit according to protocol.

The Leading Causes of Death in the U.S. (2010)*
Cause of DeathNumber of Deaths in 2010Percent of Total Deaths
Heart disease597,68924.2
Cancer (malignant neoplasms)574,74323.3
Stroke (cerebrovascular diseases)129,476 5.2
Chronic lower respiratory disease138,080 5.6
Accidents120,859 4.9
Alzheimer disease 83,494 3.4
Diabetes mellitus 69,071 2.8
Influenza and pneumonia 50,097 2.0
Nephritis, nephrotic syndrome, and nephrosis 50,476 2.0
Septicemia 34,812 1.6
Suicide (intentional self-harm) 38,364 1.6
Chronic liver disease and cirrhosis 31,903 1.3
Essential hypertension and hypertensive renal disease 26,634 1.1
Parkinson disease 22,032 0.9

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