COVID-19: Verification of death

The government has released new guidance about the verifying the death of patients outside of hospital settings. They have put measures in place to enable Registered Nurses to complete verification of death (VOD).

VOD can be performed by Registered Nurses who have been trained to do so, or by Registered Nurses who are not trained but utilise the relevant remote clinical support.

Remote clinical support:

  • During core practice hours, call the patient’s registered general practice
  • Outside core practice hours call NHS111 where a clinician will provide remote support to work through the verification process.
The verification process

Equipment that you will need to assist in VOD:

  • Pen torch or mobile phone torch
  • Stethoscope (optional)
  • Watch or digital watch timer
  • Appropriate PPE
Process of verification during COVID-19
  1. Check the identity of the person
  2. Record the full name, DOB, address, NHS number and ideally next of kin details
  3. The time of death is recorded as the time at which verification criteria are fulfilled.
Confirming death

please follow the points below when verifying a patient has died:

Neurological system
• Check pupils are dilated and fixed (unresponsive to light directed into both eyes using a torch)
• Check there is no response to painful stimuli. If you squeeze the trapezius muscle (between the neck and the shoulder) do they respond?
Respiratory system
• Check that there is no movement of the chest wall for 3 minutes by observing the chest
Circulatory system
• Advise verifier to find the site of the carotid pulse and check for 1 minute that the pulse is absent
Re-assessment
• Wait for 10 minutes and repeat all the actions above
Recording that verification has been completed
It is important to see if there are any local policies available where you are working. If not, please ensure that you document the following:
  • Full name, date of birth, address, and NHS number (if available) of the patient whose death is being verified
  • Name of the person verifying
  • Role of the person verifying
  • Who is present
  • Circumstances of death (location, who first noted it, anyone present at the time of death)
  • The outcome of verification, including the time of death
  • Any discussions with staff or relatives
  • Any concerns from staff or relatives
Unexpected deaths
Any unexpected death (adult or child) must be notified to the coroner. Any time death is reported to the coroner, there MUST NOT be any removal of lines/devices/tracheostomy tubes etc without the expressed permission of the coroner.

Care of the deceased patient
Please ensure that you follow this guidance when caring for deceased patients, including wearing appropriate PPE:

Care of deceased patients with a suspected or confirmed case of COVID-19

Verifying death in times of emergency