Managing sudden death in hospital

Deaths in hospital are common: in 2008-9, 246 525 people died in English NHS institutions alone.1 Such deaths may be anticipated or sudden and unexpected; they may result from disease or from trauma.2 Unexpected, and often premature, deaths can be challenging to manage: the family may have had no time to prepare for the bereavement, and they may not even be aware that the deceased had been admitted to hospital (see case 1 and 2 scenarios, part 1). Information necessary for the death to be managed sensitively (for example, about the person’s cultural and religious beliefs) may be unavailable. A death whose cause is unknown or unnatural will prompt a coroner’s inquest and perhaps a criminal investigation. Sudden deaths often occur in acute care areas, such as the emergency department, where clinical pressures conspire to divert the focus of care from the deceased’s family. These circumstances increase the potential for suboptimal care, adding to a family’s distress.