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NurseSavvy Cheat SheetProcedure

Postmortem Care

Postmortem care begins immediately after death is pronounced by an authorized provider. The nurse first verifies the pronouncement and time of death are documented, then cares for the body with dignity while supporting the grieving family. Most body preparation must happen before rigor mortis sets in (typically 2-4 hours). The single most important decision comes first: is this a coroner/medical-examiner case or an organ-donation candidate? If so, leave all tubes and lines in place and preserve the body as found.

Sequence after death is pronounced

  1. Verify pronouncementtime of death documented
  2. Honor cultural/religious wishesask family; facilitate rituals
  3. Coroner case or donation?if yes: leave lines in, preserve body
  4. Dignified body caresupine, head up 15-30°, dentures in, eyes/mouth closed, lines out if not coroner, ID tags
  5. Allow family timestay or step out per their preference
  6. Transport per policy
Rigor mortis onset 2-4 hours Hallmark
do dentures and positioning before stiffening
Dependent lividity (livor mortis)
flat positioning causes facial discoloration
Postmortem drainage
place absorbent pads under body
Skin-on-skin contact points
pad to prevent discoloration at viewing

Postmortem care is fundamentally dignified, respectful care of the body paired with grief support for the family. The pivotal interpretation is whether the death is routine versus a coroner/ME or donation case — this single determination dictates whether the nurse may clean the body and remove devices at all.

Routine death vs coroner/ME case

Routine / expectedCoroner-ME / donation
TriggersExpected death, no autopsy requiredDeath <24h of admit, unexpected, trauma, suicide, or donation candidate
Tubes and linesRemove after pronouncementLeave ALL in place undisturbed
Cleaning woundsBathe and clean bodyDo not clean; preserve as found
First actionSupport family, position bodyNotify medical examiner / OPO

Routine / expected

Triggers
Expected death, no autopsy required
Tubes and lines
Remove after pronouncement
Cleaning wounds
Bathe and clean body
First action
Support family, position body

Coroner-ME / donation

Triggers
Death <24h of admit, unexpected, trauma, suicide, or donation candidate
Tubes and lines
Leave ALL in place undisturbed
Cleaning wounds
Do not clean; preserve as found
First action
Notify medical examiner / OPO
Invite family presence
they may wish to be present or participate
Facilitate religious rituals
provide private space; designated members perform sacred washing
Inventory belongings with witness
document each item
Offer grief support resources
Report Nowescalate immediately
Coroner/ME case suspected Hallmark
unexpected death, trauma, suicide, or <24h of admission
Removing lines before ME notified
destroys forensic evidence — do NOT
Cleaning wounds in a forensic case
preserve body as found
Organ-donation eligibility
contact OPO before any postmortem intervention; leave lines in

Clinical Pearl

Identify a coroner case BEFORE you remove anything — dentures IN, tubes OUT, unless the coroner says otherwise.

NurseSavvy™·nursesavvy.com

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