Reviewing Death Confirmation Procedures - Osce Revision With Dr Gill 

props to the guy who had to die for this video. The world needs more professionals like him with that kind of dedication.

Shoutout to the guy on the bed. Outstanding performance

The fact this guy gave his life for this video is incredible. Mad respect

Really appreciate the warning at the beginning, but this actually brings me a great sense of calm and reassurance. I lost my mum about three years ago now (feels more recent) and the respect and professionalism shown here actually strangely makes me feel more comforted to know that she was taken care of at the end, because she passed before any of us could be there. The respect doctors and healthcare workers (and those in the funeral industry) show to every person is wonderful. I know the NHS doesn't always get things right with every case but this reassures me.

Let me tell everyone who may have to do this one day, as an RN who has had to confirm death, those are the longest minutes of your life, all of the family is watching you, you may be crazy busy, you may be having the worst day- but I promise you aren’t having as bad of a day as the family in that room. Take a few extra minutes before you run out to confirm that the family is ok, and that you put the patients blankets/shirt back on. It preserves dignity and provides comfort to the family, who will often remain bedside post expiration for a while. Our care also does not end with death, for example we do a post mortem wash of patients. You can ask the families if they wish to help at this stage, it often fosters feelings of closure and closeness, especially for people who’s love language is acts of service.

I imagine this is not an easy thing to do, but I'm glad that it is done with dignity and respect as you have shown here. Thanks Dr. Gill - very informative - my neighbour is a hospice nurse so this is an interesting perspective to see.

I work in a nursing home and have watched my nurses verify deaths several times. One interesting thing many of those deaths have in common is difficulty confirming the stopping of breathing and heartbeat. Most of our patients are given morphine to manage pain in their last days; morphine can drastically slow and weaken both respirations and heartbeat. With little old people, that slowing and weakening can be _incredibly_ drastic. Once, my nurse took three minutes sitting with her stethoscope before finally declaring the patient still alive, though the patient did ultimately pass less than an hour later. Definitely one of the most difficult things a nurse in long-term care has to do!

The content warning is massively appreciated, Dr. Gill. I love your content, but I was nervous about watching this. Thankfully, you were respectful and empathic, as always, and I learned a lot. Happy holidays to you and yours.

When my uncle dropped dead suddenly mid conversation at work 4 years ago and wasn’t able to be revived at the hospital my dad was told that the paramedics did everything they could and then a doctor worked on him with the assistance of a nurse far longer than was probably necessary and they even had a chaplain perform last rights on him in the process and as sudden and shocking and traumatic as that was to experience it was very comforting knowing that they did everything they could for him and treated him so well in his final moments. It’s nice to see the confirmation process and how it’s gone about because for me it’s cathartic in processing his death which initially I didn’t understand due to shock and took some time to truly sink in. Thank you so much for sharing this!

My dad died in 2019 of lung cancer. I remember watching his last breath and then going and getting the doctor to verify death . I don't remember them doing quite so much but they probably did. This video does make me relive it and it was traumatic (I couldn't get his eyes to shut so we left him staring at the ceiling which was horrible) , but it's also still interesting from a medical perspective. It will happen to us all eventually!

The mention of finding a pacemaker is important. Some pacemakers have a defibrillator built within it. Once death is confirmed, I understand a strong magnet is held over the pacemaker/defibrillator in order to make it stop trying to restart the heart ❤ Not all pacemakers have defibrillators which would then make the need of a strong magnet unnecessary.

My father died last year after a long illness, while it was expected it also happened very suddenly one night. The rest home hospital nurses confirmed death had occurred and called me. It's nice to see this demonstrated as they had always been very caring and professional while helping my father, this would have been the final act of care for him.

I have to say that I'm an engineer, nothing related with medicine, but Dr Gill makes every topic so interesting, that I watched the other exam videos, superb work Dr and my congratulations, your videos reaches people like me, not medicine but intestedoin it. Congrats from Colombia!

I learn something interesting from every video. I would never have guessed that a family member would choose to remain in the room while the doctor confirmed death. I'd want to be a million miles away, but appreciate the fact that Dr. Gill gives the family the option to remain or leave.

Fascinating to see how doctors do it in hospitals, our process in the Ambulance Service is similar but has some differences; we'll almost always take a 4 lead ECG to verify asystole since we always have the monitor with us anyway. The way one speaks to the patient's family during and after the exam can make all the difference, and compassionate professionalism is an essential part of verifying death in my opinion. I hope you'll forgive an anecdote. We were called first thing in the morning to an elderly gentleman who had been found not breathing by his wife of over 60 years. We found him in bed, cold and rigored, having clearly died several hours previously in his sleep, I spoke to his wife, who I think already knew what had happened, and her biggest concern was that she had wasted our time. Nonsense of course, we made her a cup of tea and sat and discussed him and his life together while she made a few phone calls and waited until her family arrived. The bit that I have never forgotten was his pose in death; he had died cuddled into his wife, with his arm draped over her and body formed to hers, and the rigor mortis preserved the peaceful serenity of his passing for me to see. I felt great joy at having witnessed a love that had endured so many years, but also a sadness at having been the one to put an official end to it. We occupy a fleeting but unique position in the lives of the families left behind, and I think it's important that we treat that with the reverence it deserves.

Dr Gill is always dead on!

I find this very comforting, my dear Dad died suddenly 2 years ago, my Mum phoned me 3 or so hours after he died (I was at work,I'm a postman and was busy) She didn't know what was done to him after he passed as obviously she was in shock as she had just lost her life partner of 50 years. So thank you for uploading this,as I know Dad was treated with dignity after he died. x

He's finally killed a man to show us the next lesson. Truly a master class experience!

I have not seen or read about this in my medical training so far, so I greatly appreciate seeing and learning about this. Thank you for making this learning moment!

Handled the topic with respect, like the professional you are. Thank you.

As a care home worker ive sadly seen this process carried out many times before. Thanks Dr Gill it's interesting to finally learn the purpose and reasoning behind each step of the verification

Informative and very sensitively handled. I've watched loads of your videos and you are clearly an outstanding medical professional.

i really love this video. your calming voice and the way you explain things had my full attention. i feel like i learned so much watching this!

I found this video not only very informative but also incredibly relaxing. The doctor's voice is so soothing.

Thanks James, very useful for junior doctors & nurses who are allowed to verify death such as those I work with in the Hospice setting 👍🏻

My daughter died in my arms a year ago, and her doctor was kind and let me hear her heartbeat before she died. I bought a stethoscope later on to remember that experience and found this channel while trying to learn how to use it. I will never forget seeing her vitals decline and watching my own child slowly slip away, despite how hard she was fighting for life. I had only held her for two hours, carried her for five months. Those memories will never fade. Hold your people close 🤍 Love them with all you've got.

So informative and enjoyable to watch. Thanks for all your hard work Dr. Gill 👍🙂

I performed this examination on myself and I'm saddened to report...Dead.

I'm not a medical practitioner, just a grateful learner of stuff. Thanks for this.

I'm a Community First Responder in England and I've had a couple of patients that didn't make it, sadly. In both cases paramedics did exactly what has been shown in this video plus temperature check (until the thermometer read "LO") and a 4-lead ECG. In one of the patients the ECG still showed some activity but we were explained by them that the small electric activity was incompatible with life. One patient had signed a "DNR" form, so when it happened we just waited to confirm the death and on the other one we were doing CPR for more than half an hour, but it was clear it was going nowhere, so all paramedics at scene (4 plus an ambulance LOM) decided to stop at some point.

The ASMR is strong with this vid, like this is sleepy time stuff, a little morbid but very informative. Cutos Dr Gill

I'm not even a medical student (I'm a bus driver 😄)but I love watching your videos,so educational 👍🏼

Not me saving this video in my favorite asmr videos list... Your voice is heavenly

Great video! As add-on: on forensic medicine classes they told us that you don't need to search for apnea and heart sounds when you have a cetrain signs of death, such as livores mortis, rigor mortis or putrefactio. Also nobody is death until is warm and dead.

i only just realized that you did did see pupils dilate, feel a pulse, and hear his heart and lungs. while watching i never even considered it. you both did such a great job!

Great video as always, Dr. Gill

Did you mean this to be ASMR-friendly? You have a wonderful speaking voice. Learning something new is the process is a bonus.

This is super interesting as someone studying to go into healthcare! Also, not to detract from an important topic but you look like Dr. House without the medical malpractice.

Dr. Gill's videos are to die for!

The ethics and respect of Dr. Gil are beyond everything i've ever seen anywhere. Outstanding video as always.

The first minute of the video and it already deserves a like.

The fact that my father has done this countless times and comes home calm as can be is crazy to me. I couldn’t.

I am a home care nurse here in Canada. I just had to do this yesterday as a patient of mine passed at home. Just as she wanted to. Her family watched as the exam was conducted. They were reassured by the gentle nature of the exam and the care their mother received. Some of my colleagues don't wish to pronounce death at home. Which I completely understand.

Hello! I’m Dr. James Gi…zzzzzzzzzzzz The asmr on your stuff knocks me out faster than Tyson ever could 😅

Fun fact: Verifying death and verifying deaf is the same exam. You shout as loudly as you can at the patient whilst observing them for a response. If they twitch, the doctor will then slap them for wasting his or her time.

I am a medical student from Israel. Beyond how your videos are known, as relaxing. I find them useful. It helps me a lot with English and to get used to medical speech in English. I have been accepted to a medical program abroad next year, and your explanations are really good and understandable.

I made the mistake of trying to watch this while grieving my dad and when it was still fresh in my head, I thoroughly enjoy ur videos Dr Gill, 3 years on and I'm giving this video another try :)

This is interesting to me as most of us modern people may never have seen or touched a dead body. We generally leave it to funeral homes… last week we had to put down my beloved cat and he felt so different after death than when alive. As always I appreciate the dignity you give the subject of your videos.

Great video ! I’m a paramedic and they never told us to check for a pacemaker and I would like to learn the reason. Thanks doc !

An observation on the bowel sounds comment...my Dad and Uncle were sitting with my grandfather shortly after he died suddenly at home (we are Irish so he was kept home all that first night to wake him) when suddenly he passed wind...loudly. Well as you can imagine my Dad got such a fright he almost passed away himself!

I am not in healthcare but this is such an educational video that I almost want to emigrate so dr. Gill can be my doctor. It's been a few years since I lost one of my own loved ones so the warning was also welcome. Also, dr. Gill, what do you write down if you weren't in the room when death occurred? The time that you determine life us extinct?

Dr. Gill can stand so perfectly still I thought the video was paused

Dr Gill, do you do any sports? You give off climber vibes, very thorough and precise with long limbs!

I try to watch all of Dr. Gill's videos. They are really informative. It was interesting what you said since I have 45/40 blockage in both of my carotid arteries. IF the patient was verified as deceased and for some unreason they were not, how would the embalming process work. Would it be caught at that time.

Dr. gill this must be the most macabre of your videos. You have often entered my ASMR dreams, but now you may enter my nightmares.

Dr gill always delivers with the asmr.but i never thought hes hit the mark witha death video

I come for the ASMR, and it is always a really nice experience every time due to the relaxation and teaching provided :)

In this case, the patient was lulled into a comatose state whilst listening to Dr. James Gill's soothingly calm voice.

This was facinating!

Whilst performing last offices I would always talk to the patient throughout telling them what I was doing such as "I just need to move your arm" etc it was a very peaceful respectful process.

This is really interesting!

I wish Dr Gill practiced here in the US. He's obviously an amazing physician.

Okay this is VERY SAD to confirm someone's death, but please hear me out. Thank you Dr.Gill for this video, I have always wanted to know how to check if someone is still with us. This might sounds bad, but we all know we can't live forever, death will come for everyone of us, that's the circle of life. It is always sad when someone leave this world, it's also very important to pay enough respect for this person, the body, the family who lost the loved one. But from the other side, death can be also interesting. When we think about our body functions when we are alive, it's very surprising how many things is being done in the process. But the same thing happens when we die. From biological and medical point, our body can be even more interesting after death. My wish is to become a mortician one day, so this video is not really needed in my future job of course, but it's still really eye opening how small things can change everything. One more time, thank you so much! 😊🙏

I wish the staff in the ICU where my mom passed had been even half this respectful. I asked a nurse if we could discuss her condition out in the hallway (she was alive but unconscious.) The woman was visibly irritated, told me she definitely couldn't understand us, then went out of her way to talk about my mom directly over top of her every time she came in the room to administer care.

Fell asleep to some ASMR playlist....woke up to this....

i immeadiatly tried to see him breathing i couldn't. good job youve bested professional actors

I was going to make a joke about how dead the patient was, or something along those lines, given how funny ASMR comments sections get, but then I actually read the comments section. It's moving to see how many people were touched by this. Kudos to Dr. Gill and I'll just shut up now.

As a former police officer (in the US) I would have to respond to deceased persons calls and would usually be first on scene. We often used many of these techniques to verify death. I’m not a medical professional by any means but we did as much as we could to verify the subject’s status prior to the fire department’s arrival so we could quickly get the right treatment ready or get the proper people notified in the event death was confirmed

Hello Dr Gill, this may seem a silly question, but have you ever been in the process of verifying a death, and found the patient was still alive? I ask because I assume from the health care worker’s point of view it’s often “visually obvious” when someone has passed, but I’m curious if “surprises” ever occur. Apologies if this comes across as an insensitive question.

I really miss the part when he introduces himself to the patient, "Hello, my name is Dr Gill, can you confirm your name and date of death?"😆

Awesome video

I feel I'd fall asleep doing this (being the "dead" body) The warning makes it clear you are amazing!

6:59 " Hello Mr Johnson can you hear me ?" Mr Johnson rising up like Lloyd Christmas "ooooooooohhhhhhhhh" in that restaurant scene in Dumb & Dumber 😂😂

Best ASMR Channel without be an ASMR Channel.

Huh. I mean it makes sense that its part of the Curriculum. Just didnt expect it.

Very interesting Dr. Gill thank you. You hear about people who say they died then came back to life. Surely if it has to be irreversible for death to be confirmed, then they hadn’t died? Also, how do you know it’s irreversible? Finally, if it’s clear they are dead (from a horrific accident for example), do you still do this test? Cheers!

Glad to understand.

He did a great job playing dead! Good video.

I’m a hospice nurse in California and I pronounce death often. It’s honestly less technical and more about supporting the family and normalizing the experience.

Got deep into a suggested video rabbit hole and ended up here. Comfy video to fall asleep to.

Dr Gill, if you haven't i'd truly appreciate a CPR tutorial as a Sort of complement to this. This Is excellent as always

Hmm, very interesting. I've unfortunately been in the room with a family member that passed away on more than one occasion and I don't recall the doctor's examination being even half as thorough as this!

Very informative.

Doctor Gill, you knock me dead every time😍

This was a very interesting video.

It did tickle me a little bit, 'We can't ask the patient in this situation to give us their name & date of birth'.

thumbnail caught me off guard with the "death exam" LMAO

As an outsider I want to say that it is not unusually about it. There is only one thing sure when you are born. It's a part of life. I used to work in the funarral world, and even There was sometimes questions how to look for some reactions of the body.

Your voice is so relaxing like asmr :)

Very good doctor...

Mr. Johnson, I need you to go lovely and floppy.. Brilliant!

It is an interesting process as strange as that sounds but I used to be a patient porter and had to regularly deal with deceased patients so I would see most of what goes on

This phrase "life has been extinguished in the patient" provides dignity and profound respect to the deceased in such a elegant manner. Absolutely Bri'ish 🧐

Mr. Johnson is looking drop dead amazing. More healthy looking than myself.

The "corpse" in this video put on a really good performance. A real working stiff!

another great video. have you had to confirm a death yet since you became a doctor.

As a funeral director this is so informative. Thank you

Curious, is there ever a situation that you have encountered or are wate of where the "irriversable" criteria disnt hold up and the person revived?

I'm writing a history exam tomorrow but this is much more interesting. Thanks James you're the best :)

In the USA, whilst the coroner (a political official or appointee) continues to have beurocratic duties -- in many places the medical examiner (non-political professionals) have taken on the duties of determining cause and manner of death.