Body condition clearly indicating biological death.
- Complete decomposition or putrefaction: the skin surface (not only in isolated areas) is bloated or ruptured, with sloughing of soft tissue, and the odor of decaying flesh.
- Dependent lividity and/or rigor: when the patient’s body is appropriately examined, there is a clear demarcation of pooled blood within the body, and/or major joints (jaw, shoulders, elbows, hips, or knees) are immovable.
Procedure for lividity and/or rigor: All of the criteria below must be established and documented in addition to lividity and/or rigor in order to withhold resuscitation:
i. Respirations are absent for at least 30 seconds; and
ii. Carotid pulse is absent for at least 30 seconds; and
<!--[if !supportLists]-->iii. Lung sounds auscultated by stethoscope bilaterally are absent for at least 30 seconds;
and
<!--[if !supportLists]-->iv. <!--[endif]-->Both pupils, if assessable, are non-reactive to light. [20]
