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Confirming brain death: This is a procedure that should be carried out by qualified specialists. It should be done by 2 doctors (one of whom must be a consultant), 1 hour apart, 6h hours post commencement of coma, and 24 hours post cardiac arrest. It is worth knowing the main criteria for exams.  Lack of pupil reaction  Lack of corneal reflex  Caloric testing  Lack of gag reflex  Lack of cough reflex  Lack of respiratory effort when taking off a ventilator After a death:  Give family the time they need to be with the patient  Ask family what they would like to do next (different religions have different laws about how quickly ceremonies need to take place and preparation of the deceased  Explain to the family that: o They can pick up the death certificate the next day from the patient affairs office in the hospital o They can collect patient's personal belongings from the patient affairs office as well o They (or another representative of the patient) are required to attend local town hall to register the death. They need the completed death certificate to be able to do this, and it should be done within 5 days of death  Explain that this should be the town hall closest to the place of death, not to the home place of the deceased  Advise that it may be worth making an appointment to ensure that they get the privacy required (as these centres are also where births, etc are registered)  Who can register a death:  The next of kin, a relative/person present at death, during last illness, or lives where the death occurred, or the person aiding in disposal of the body  What to take:  Death certificate  Birth and marriage certificate  NHS card  What they will ask:  Name and date of birth of the deceased  Their occupation www.osce-aid.co.uk 