University Hospitals Division

CARE OF DECEASED PATIENT PROTOCOL (May10)

Contents

1. WARD / DEPARTMENT STAFF - LAST OFFICES ...... 1 2a. PORTERING STAFF - TRANSFER TO MORTUARY...... 4 2b. PORTERING STAFF - BARIATRIC PATIENT TRANSFER TO MORTUARY ...... 6 3. MORTUARY STAFF – PROCEDURES FOR RECEIVING, STORING & RELEASING BODIES .. 6 4. CARE OF DECEASED PATIENT PROTOCOL – CHECKLIST ...... 13 APPENDIX 1: MORTUARY CARDS DC1 & DC2 ...... 14 APPENDIX 2: BARIATRIC DECEASED PATIENT PATHWAY ...... 15

1. WARD / DEPARTMENT STAFF - LAST OFFICES

Action Rationale 1.1 Nurse in charge of the ward should inform To confirm that death has occurred before medical staff. A doctor must usually verify last offices are carried out. death, unless it is an ‘expected’ death verified by an appropriately trained RN in accordance with NHS Lothian’s Nurse Verification of Expected Death Policy and Procedure. 1.2 Medical staff should respond timeously to the To prevent any undue delays that may cause request to verify the death of patient. They distress. must ensure that all relevant documentation is completed and that their contact details are available should they need to be contacted regarding these. 1.3 Inform and offer support to relatives and / or To ensure relevant individuals are aware of next of kin. Offer support of Chaplain or other patient’s death. To provide support and care. religious leader / appropriate person. 1.4 Check that an Infection & Contamination To prevent cross infection to health care staff Control Notification Form has been and funeral directors. completed. For deceased carrying known risk of infection, refer to Infection Control Manual section CP0031 on Last Offices. 1.5 Screen bed / close door / draw blinds. To ensure privacy and conducive Consider moving the deceased to a discrete environment for family viewing (if required). area to perform last offices if possible / appropriate. 1.6 If death has occurred in an area where other It is important to offer support and people are present, e.g. an open ward, it may reassurance, to allay any fears and be appropriate to briefly inform other patients misconceptions. of the situation. 1.7 Collect the mortuary box or assemble the To ensure that the procedure can be carried following on the bottom shelf of a trolley. out effectively and without interruption. . Bandage

1 . Gauze swabs . Cotton wool . Scissors . Oral hygiene tray . Adhesive tape (water proof) . Mortuary gown / night attire / or according to relatives’ wishes . Perineal pad / pants . ID Bands . Mortuary labels DC1 and DC2 . Sheet . Disposal bag & cellotape . Bag(s) for belongings . Receptacle for soiled linen

The following may also be required: . Shaving foam / razor If required to shave male patients. . Body bag / bariatric body bag If required for leakage / infection risk. . Double sheet If required to wrap bariatric bodies.

1.8 Put on gloves, aprons and any other To reduce the risk of cross-infection and appropriate protection (e.g. goggles, gowns contamination with bodily fluids. and masks if deceased is highly infectious). 1.9 Strip the bed to the bottom sheet leaving For dignity. To facilitate lateral transfer to deceased with one pillow and covered with a concealment trolley. sheet. A long bed sheet must be left free under the deceased. 1.10 Lay the deceased on back and straighten For dignity and future care of the body, as limbs. rigor mortis can begin a short time after death. 1.11 Close the jaw and support it by placing a To hold the jaw closed and improve final pillow or rolled-up towel on the chest appearance. underneath the chin. If the deceased wore dentures, put them in before closing the mouth. 1.12 Close eyes by applying light pressure to the For dignity and aesthetic reasons. Closure of eyelids for 30 seconds. If eyes will not stay eyes will also provide tissue protection in closed, place moistened cotton wool balls case of corneal donation. over eyelids until they remain closed without Taping eyes can leave unsightly marks assistance. Do not tape eyes closed. 1.13 If necessary, drain the bladder by gently To prevent leakage and cross-infection as the applying pressure over the abdomen. Leave body can continue to excrete fluids after colostomy or urostomy bag intact, or renew if death. full. 1.14 In cases where the death is referred to the To enable the Procurator Fiscal to distinguish Procurator Fiscal, endo-tracheal tubes, IV injuries from appropriate medical lines, etc. may be removed and recorded as interventions. per sections 2.12-2.14 of NHS Lothian’s Deaths in Hospital Policy. If there is any suspicion, all evidence that may be related to

2 the death must be retained. 1.15 Remove urethral catheter, drains, tubes, The risk of leakage of body fluids should be intravenous infusions and dressings and remembered and suitable precautions taken. place in clinical waste. Do not remove PEG tubes. Do not remove sutures or clips. Apply a firm waterproof dressing to wounds or puncture sites. 1.16 Remove drainage tubes, etc., unless Open drainage sites present a health hazard otherwise stated, and document actions and to staff or others coming into contact with the any tubes remaining, e.g. Hickman lines. body. Open dressing sites may need to be sealed with an occlusive dressing (e.g. Tegaderm). 1.17 Cover any exuding wounds with a clean To absorb any leakage from the wound site. absorbent dressing and secure with an Open wounds pose a health hazard to staff or occlusive dressing (e.g. Tegaderm). others coming into contact with the body. 1.18 Pack orifices with gauze or gauze tape ONLY Leaking orifices may pose a health hazard to if fluid secretion continues or is anticipated or staff or others coming into contact with the if other criteria set out in Clinical Protocol body. for Last Offices – Packing are met. If excessive leaking of body fluids occurs, consider suctioning. 1.19 Remove all jewellery including the wedding To meet relatives’ wishes and ensure ring, unless otherwise requested. Document adequate documentation regarding all jewellery and follow Policy for Patients’ deceased’s belongings / valuables. Funds and Valuables. Any jewellery left on the deceased must be securely taped in place and noted on the mortuary card (DC1). 1.20 Wash the deceased, unless requested not to For hygienic and aesthetic reasons, whilst do so for religious / cultural reasons (ask respecting individuals’ wishes. family and/or refer to NES Multi-Faith Resource for guidance on individual faiths). 1.21 Clean the mouth using a toothbrush or foam For hygienic and aesthetic reasons. stick to remove any debris and secretions. Clean dentures and replace them in the mouth if possible. 1.22 Other aspects of care include: cleaning hair For hygienic and aesthetic reasons. and nails, and shaving the deceased (if appropriate – in certain religions this is forbidden or the deceased may have chosen to grow a beard). 1.23 Leave identification band in place, or replace To ensure correct and easy identification of if soiled. Attach second ID band to the ankle. the body in the mortuary. 1.24 Dress deceased in a hospital gown or own For dignity and respect. clothes, depending on what is available, appropriate and / or family preference. 1.25 Wrap the deceased in a sheet, ensuring that For dignity and to avoid movement and face and feet are covered and all limbs are possible damage during transfer. held securely in position. If the body is too large to be securely wrapped in a standard sheet, a double sheet should be obtained

3 from the Site Co-ordinator / OOH Office. 1.26 Secure the sheet with tape. Pins must not be used as they are hazardous to staff. 1.27 A body bag must ONLY be used if leakage of Actual or potential leakage of fluid, whether body fluids is a problem or if the deceased infection is present or not, may be hazardous had certain infectious diseases (refer to to those who come into contact with the body. Infection Control Manual section on Last However, the use of a body bag may hamper Offices). If the deceased’s weight / size / the moving and handling of the body, and shape means a standard body bag is not may hasten decomposition, so should only be appropriate, a bariatric body bag should be considered when necessary. obtained from the Site Co-ordinator / OOH Office. Refer to NHSL Manual Handling Guidelines for further guidance on the handling of a bariatric body in to a body bag.

See also: packing deceased (section 1.18) 1.28 Complete mortuary cards. Attach DC2 to To ensure correct and easy identification of sheet or outside of body bag (if used) at the body in the mortuary deceased’s chest level. Leave DC1 and Infection & Contamination Control Notification Form on bedside locker / hand to the porter on collection. 1.29 Confirm all documentation complete and For completeness and accountability. accurate, signed, dated and timed and that the last offices checklist is complete. 1.30 Contact portering staff to arrange removal of Decomposition occurs rapidly, particularly in the body from the ward and transfer to hot weather and in overheated rooms. Many mortuary. pathogenic organisms survive for some time after death and so decomposition may pose a health and safety hazard for those handling the body (Cooke 2000). Autolysis and growth of bacteria are delayed if the body is cooled. Patients and relatives may be distressed by body remaining on ward some time after death. 1.31 Provide the portering staff with information on To enable staff to make informed choices the patient’s weight and size when requesting regarding equipment required and staff transfer to mortuary. available to assist. 1.32 Prepare the environment prior to portering To ensure that a lateral transfer can be safely staff arriving. This may also include removing performed. some furniture from the bed space e.g. patient chair, locker. Ensure that a long bed sheet is free underneath the deceased and that a glidesheet is available.

2a. PORTERING STAFF - TRANSFER TO MORTUARY

Action Rationale 2a.1 Identify the necessary equipment and To facilitate a safe system of work.

4 number of staff required to safely carry out transfer, based on details given of deceased’s weight and / or size. 2a.2 If deceased’s weight exceeds the To facilitate a safe system of work when concealment trolley’s Safe Working Limit transporting the larger deceased patient. (SWL) of 30 stones / 190kg and / or if the size / shape exceeds the trolley’s dimensions, refer to alternative procedure below and Appendix 2. 2a.3 Collect the concealment trolley from the To ensure correct transport equipment is designated area and take it to the ward (refer available for moving the deceased patient to NHS Lothian Manual Handling Guidelines section Deceased Patient Handling Procedure - Preparation) 2a.4 On arrival, porters should pick up the To ensure that all necessary documentation Infection & Contamination Control has been completed before transferring the Notification Form and Mortuary Card DC1. deceased to the mortuary. 2a.5 Porters should request assistance from at To ensure that lateral transfer is carried out least one member of staff from the ward who with the correct number of staff required as will lead the lateral transfer of deceased onto per NHS Lothian Manual Handling the concealment trolley using lateral transfer Guidelines manoeuvre (refer to Manual Handling Guidelines section on Lateral Transfers) 2a.6 Raise sides of the trolley and place cover To ensure safe and discrete transfer of the over the deceased. deceased. 2a.7 One handler should push the trolley from the To assist the trolley to move well therefore head/foot end, whilst the other handler reducing the effort required from staff. assists by guiding the trolley at the opposite end. 2a.8 The directional locks should be used to allow To reduce effort required and to facilitate the trolley to be pushed in a straight line. safe transportation of the deceased to the These may be disengaged to negotiate Mortuary. tighter corners, etc, and then reinstated. 2a.9 On arrival at Mortuary, porters will select and To facilitate a safe system of work for transfer the deceased into an appropriate handling the deceased within the Mortuary. fridge compartment. (Refer to Manual Handling Guidelines section Deceased Patient Handling Procedure – Mortuary). Mortuary staff may assist, if available. 2a.10 If Mortuary staff are not available, porters To ensure that the correct number of should seek additional assistance if required handlers is used. from ward staff/hospital at night team/site co- ordinator. 2a.11 Where possible the middle tiers of the fridge To enable staff to work at more efficient should be used. heights. 2a.12 The electrically operated loading trolley in To facilitate safe handling the deceased mortuary should be utilised for shelves within the Mortuary. higher than concealment trolley capacity. 2a.13 The Infection and Contamination Control To ensure that essential information is kept Notification Form and Mortuary Card DC1 with the body at all times.

5 should be clipped to the door of the fridge compartment. 2a.14 Once finished with the porters should put To ensure that it is ready for next use. concealment trolley back on charge in mortuary.

2b. PORTERING STAFF - BARIATRIC PATIENT TRANSFER TO MORTUARY See also Pathway: Appendix 2

Action Rationale 2b.1 If the deceased’s weight exceeds the To facilitate a safe system of work when concealment trolley’s Safe Working Limit transporting the larger deceased patient. (SWL) of 30 stones / 190kg and/or if the size / shape exceeds the trolley’s dimensions, they must be transferred to the Mortuary on the bed. Where available, porters should bring an electric bed mover to the ward. 2b.2 Raise bed rails and transport to the Mortuary To ensure the deceased patient remains using electric bed mover if possible. If this is safely on the bed during transportation. not available, at least 4 staff members may The increased weight will increase the manually transport the bed. pushing/pulling forces, therefore more staff need to be involved to share the load or the task should be mechanised. 2b.3 Portering staff to transfer the patient into the To facilitate a safe system of work when fridge, using a bariatric compartment if handling the larger body. possible. (refer to Manual Handling Guidelines section on Body Uplifting Procedure – Mortuary). Mortuary staff may assist, if available. If Mortuary staff are not available, porters should seek assistance as required from ward staff/hospital at night team/site co-ordinator. 2b.4 All necessary transfers in the mortuary To ensure that the correct equipment and should be carried out with a sufficient number of handlers is used. number of handlers, using appropriate handling equipment such as patslide, glidesheets or Liko Viking XL mobile hoist (refer to Manual Handling Guidelines for information on how to use this). 2b.5 The Infection and Contamination Control To ensure that essential information is kept Notification Form and Mortuary Card DC1 with the body at all times. should be clipped to the door of the fridge compartment.

3. MORTUARY STAFF – PROCEDURES FOR RECEIVING, STORING & RELEASING BODIES

Action Rationale 3.1 TRANSFER AND RECEIPT OF BODIES

6 3.1.1 Body transferred to mortuary by:

WGH, RVH, Liberton – NHSL porters SCRH – Uplifted directly by mortuary staff RIE – Haden porters or external sources, Bodies may need to be transported to RIE e.g. BGH, FPMH, Procurator Fiscal or other for post mortem examination NHSL sites SJH – NHSL porters or police for PF cases The fiscal may need to use the mortuary body storage facilities. 3.1.2 Mortuary staff (or porters if mortuary staff To ensure correct and easy identification of are not available) must check that fully the body. completed ID bands are attached to wrist and ankle.

If ID bands are missing or incomplete, a member of ward staff must be summoned to identify the deceased and complete / attach the ID bands.

Exception: SJH Police Cases: It is the responsibility of the police officer logging the body into the mortuary to ensure it is identified and labelled correctly. 3.1.3 Porters place body in fridge. Mortuary staff Mortuary staff are not always available. may assist, if available. Mortuary staff are only responsible for the body once it is placed in fridge. 3.1.4 The Mortuary Card DC1 and Infection & To ensure that essential information is kept Contamination Control Notification Form with the body at all times. are clipped to the outside of the fridge door. 3.1.5 Details of deceased’s name and fridge To ensure correct and easy location of the number are recorded on the mortuary notice body. board (or register at SJH) located in the body storage area.

3.2 MORTUARY STAFF DUTIES RIE, WGH, SJH 3.2.1 At the start of each working day mortuary To ensure correct and easy identification staff will check that correct procedures have and location of the body. been followed for any bodies checked in by porters overnight / weekend. 3.2.2 Mortuary staff will measure the length, width To minimise delays by enabling the funeral and depth of a body and enter details in the director to prepare coffin. mortuary register. These details will be supplied to the funeral The number may be dialled incorrectly. The director on request. Under no circumstances relevant person may not receive the should any return messages to funeral message. directors be left on answer machines. 3.2.3 Central Admissions will contact the Mortuary To ensure accurate hospital records/stats. daily at 8.30am. They should be notified about the previous day’s deaths. The

7 information they require is: Name, unit number, ward, doa, dod. 3.2.4 Cremation papers. If Part B has not been A body for cremation cannot be released to completed, the mortuary staff will request it a funeral director until all the paperwork is from the attending Junior Medical Staff on completed. the ward in which the patient died. The ward or mortuary staff will then arrange for Part C to be completed. 3.2.5 Medical Certificate of Cause of Death. The To ensure that they are issued to the ward staff normally handle this but appropriate person. occasionally a funeral director will collect it for the family. Bodies for release with a death certificate can only be released by Mortuary staff during working hours.

3.3 PROCEDURE and PREPARATION for VIEWING 3.3.1 Relatives must contact the ward where the To ensure staff availability. patient died to arrange a viewing. 3.3.2 During normal working hours, ward staff To ensure staff availability. must contact the mortuary staff to arrange a suitable time for viewing. Out of hours viewings must be arranged by To arrange access to the mortuary out of the nurse in charge, who contacts: hours. RIE – Haden Site Manager – 24242 WGH - Portering Site Manager or Clinical Nurse Manager SJH – Portering Site Manager or Clinical Nurse Manager 3.3.3 The mortuary or porting staff (if out of hours) To ensure that consistent process is will lay out the body for viewing as described followed. below. 3.3.4 Identify the correct fridge by checking notice Extremely important that the correct body is board (register at SJH). Remove body and laid out. check the shroud label DC2 and the ID wristband. 3.3.5 Open the external sheet and fold back the To ensure a dignified appearance. top half so that it covers the top of the metal tray and trolley. 3.3.6 Place a pillow under the head and brush or To ensure a dignified appearance. comb the hair if necessary. 3.3.7 If the eyes or mouth cannot be closed To ensure a dignified appearance. naturally, the following methods can be tried. Lift the eyelid with a pair of forceps and place a wisp of cotton wool over the eyeball, then draw the eyelid down gently. If the mouth cannot be closed place a towel round the neck and draw the chin up tucking the towel neatly and tightly under the shoulders.

8 3.3.8 Check that the pall cloth is clean and To ensure a dignified appearance. presentable. Place the cloth over the body ensuring it is evenly spread out to cover the body and trolley. 3.3.9 The body is then transferred to the viewing area. 3.3.10 A member of the ward’s nursing staff must To provide support to relatives escort relatives to the bereavement suite. In certain circumstances the Bereavement Coordinator or a chaplain may escort relatives. 3.3.11 The mortuary staff / porter must check the To double check that it is the correct patient full name and identify of the deceased with and that they have been laid out in an the member of staff, before showing appropriate and dignified manner. relatives into the viewing area. 3.3.12 Once the viewing is completed the body should be re-wrapped securely and returned feet first to the correct fridge compartment.

3.4 RELEASE OF BODIES DURING WOKING HOURS 3.4.1 Bodies will only be released to accredited To ensure that the body is release to bona funeral directors or other appropriate fide persons in accordance with the family’s persons instructed by the family. instructions. Mortuary staff will ensure that any person attending to collect a body is bona fide. 3.4.2 All necessary paperwork must be completed and in the possession of the mortuary staff before the body can be released.

Bodies released for burial require: To ensure those handling the body are Infection & Contamination Control informed of any potential infection or Notification Form contamination risks.

Bodies released for cremation require: Infection & Contamination Control As above. Notification Form Cremation Forms B & C To enable cremation to proceed. (these must be placed in a sealed envelope, Envelope necessary to protect confidentiality with the deceased’s name, unit number, of the deceased. DOB and the names and addresses of the two doctors who completed the forms written on the front). 3.4.3 Mortuary staff will check notice board (or To locate the correct body. register at SJH) and confirm fridge number. 3.4.4 Mortuary staff will check deceased’s name To ensure that the correct body is released. and ward on ID wristband and shroud label DC2. 3.4.5 Mortuary staff and funeral director MUST To double check that the correct body is DOUBLE CHECK AND CONFIRM the released.

9 deceased’s identity on wristband 3.4.6 Mortuary staff give the relevant paperwork to the funeral director. 3.4.7 The mortuary staff and funeral director must To ensure accountability and traceability of BOTH sign the mortuary register and only staff involved in every transaction. then will the body be released.

3.5 RELEASE OF BODIES OUT OF HOURS 3.5.1 The funeral director must contact the To ensure that the person arranging the relevant member of staff to arrange a release has the authority and ability to do removal: so. RIE – Haden Services 0131 242 7015 WGH – Site Manager 0131 537 1000 SJH – Site Manager or Clinical Nurse Manager 01506 522084

3.5.2 The member of staff arranging release of the To ensure correct and consistent process is body must follow the steps described above followed. in Sections 3.4.1 to 3.4.7.

3.6 RELEASE OF BODIES DIRECTLY FROM WARD 3.6.1 On rare occasions the family may request Removal via the mortuary ensures that for religious or other reasons that the body correct procedures are followed for transfer, be removed directly from the ward. In such documentation and release. It also ensures cases it is advisable that the body is that the body is transferred via a discreet removed to the mortuary area for immediate and dignified route / location. transfer to the funeral directors. This can be carried out either during or out of normal hours.

If the relatives do not agree to this, the body may still be released. The ward staff must ensure that all necessary paperwork has been completed before they release the body from the ward.

The mortuary staff must be notified as soon To allow the relevant details to be entered as possible that the patient has died and a into the mortuary register. DC1 card should be sent to the mortuary.

3.7 UNCLAIMED BODIES 3.7.1 If a body is in the mortuary after 5 days and To ensure that appropriate action is taken no contact has been made by anyone about when bodies are not claimed by family or disposal / removal the following procedure when there are no known relatives. should be carried out and the attached form completed in all cases 3.7.2 Mortuary staff contact the nurse in charge of To establish whether there are any known ward where the patient died. Check if the reasons for the delay.

10 deceased had any family or a designated social worker and if they are aware of any reason for a delay in arranging the funeral e.g. waiting for relatives travelling a long distance or on holiday. 3.7.3 Mortuary staff to ascertain from the ward To establish whether any individual has staff who has the death certificate. taken responsibility for registering the death, and if so, whom. If the family has the death certificate, ask the nursing staff to could contact the family and ask what their plans are.

If the social worker has the death certificate, mortuary staff to contact social worker to ask what the plans are.

If death certificate is still in the ward and the patient has no family, the mortuary staff will ask the ward staff whether the death has been referred to the Cashier’s Office (RIE) or Patient Liaison Office (WGH/SJH) for an indigent funeral. If not, ask the ward staff to refer the case to appropriate office. 3.7.4 If the body has not been uplifted within a To ensure that prompt action is taken. further 48 hours, mortuary staff will contact appropriate department, i.e. ward, Social Worker, Cashier’s Office or Patient Liaison Office, to ascertain reason for the delay. Mortuary staff should inform the Clinical Manager for Pathology of this delay.

REFERENCES:

Dougherty, L., Lister, S. (2008) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. Oxford: Blackwell Publishing. Higgins, D. (2008) Carrying out last offices Part 1 - Preparing for the Procedure. Nursing Times; 104: 37, 20-21. Higgins, D. (2008) Carrying out last offices 2 - Preparation of the body. Nursing Times; 104: 38, 24- 25. NHS Education for Scotland (2006) A Multi-faith Resource for Healthcare Staff

11

MORTUARY STAFF CHECKLIST FOR UNCLAIMED BODIES

Patients name ______

Unit number______Ward______

Date of Death______

Ward contacted on ______

Person contacted / Name and Grade______

Response______

Further Action Required Yes No

If yes what action taken ______

Date completed______

MTO signature______

12 4. CARE OF DECEASED PATIENT PROTOCOL – CHECKLIST

Please circle appropriate answer to every point.

Before Commencing Last Offices

Death verified Yes Next of kin / relatives notified Yes No Religious and cultural requirements checked Yes No N/A Infection & Contamination Control Form completed and checked Yes

Last Offices Procedure

Limbs straightened Yes No Eyes closed Yes No Jaw closed and supported Yes No Tubes etc removed Yes No N/A Wounds covered with absorbent waterproof dressings Yes No N/A Bladder drained, if necessary Yes No N/A Orifices packed, if necessary Yes No N/A Deceased washed and made presentable Yes No N/A Mouth cleaned Yes No N/A Dentures cleaned and in mouth Yes No N/A Deceased dressed in clothes / gown / shroud Yes No Jewellery removed and documented Yes No N/A 2 x identity bands attached (wrist and ankle) Yes No Deceased wrapped in sheet and secured with tape Yes No Body bag used (only required for leakage or infection risk) Yes No N/A 2 x mortuary cards completed (DC2 attached to outside of sheet, Yes No DC1 to give to porter) dated, timed and named.

Certification & Medico-legal Issues Death reported to Procurator Fiscal? Yes No N/A Death reported to Infection Control Nurse due to HAI? Yes No N/A Content of Medical Certificate of Cause of Death discussed and Yes No agreed with Consultant? Medical Certificate of Cause of Death (Form 11) completed? Yes No Cremation Form (Part B) completed (unless known to be burial)? Yes No Burial Body to be donated to medical science? Yes No

Signature of Nurse ……………………………………………….

Name of Nurse (PRINT) ……………………………………………….

Date …./…./…. Time ………

File in nursing records on completion.

13 APPENDIX 1: MORTUARY CARDS DC1 & DC2

14 APPENDIX 2: BARIATRIC DECEASED PATIENT PATHWAY

1. Patient dies.

2. Death verified.

3. NOK informed, opportunity to view on ward.

4. Last offices completed as per protocol.

5. Body can be wrapped securely in regular sheet?

Yes No Wrap body as per last offices Obtain double sheet from Site protocol Coordinator / OOH Office. Wrap body as per last offices protocol.

6. Body (once securely wrapped) exceeds size dimensions or SWL (30 stones / 190kg) of concealment trolley?

No Yes

Either: Transfer to concealment Obtain repo sheet from Site

trolley by lateral transfer. Coordinator / OOH Office.

Or, if lateral transfer assessed as Place repo sheet under body.

unsafe then obtain repo sheet (see Transfer to Mortuary on bed using

right) and transfer to concealment electric bed mover or minimum of 4

trolley using hoist. staff if moving manually.

Transfer to Mortuary in concealment

trolley.

7. Body size exceeds dimensions of mortuary fridge?

No – NB RIE, WGH & SJH all have Yes – Liberton / RVH bariatric fridge compartments. Complete paperwork and request urgent Go to step 8. collection by Funeral Directors. If collection not possible within 12 hours of death, consider transfer to site with bariatric fridge compartment.

8. Body weight exceeds SWL (30 stones / 190kg)?

No Yes, or if lateral transfer assessed Transfer to fridge using lateral transfer. as unsafe Use bariatric compartment if available / Transfer to fridge using hoist. required. Use bariatric compartment if available / 15 required.