Evaluation of Paediatric Death Pronouncement from a Resource-Limited Country

Death pronouncement (DP) in children is quite challenging and distressing, especially for junior paediatric residents. This study aims to evaluate the implementation of the WHO international criteria for the determination of death in Paediatric patients. A retrospective chart review was conducted on the death declaration notes of 165 patients who died in the Paediatric Intensive Care Unit of Sindh Institute of Child Health Neonatology, Karachi, Pakistan, between January and June 2023. The median age of the patients was 12 (6.7-19) months, and 58% (n = 96) were male. Infectious-related illnesses accounted for 37.6% (n = 62) of the cases. The documentation of absence of breathing, heartbeat, response to painful stimuli, and a flat line on electrocardiogram was not mentioned in 74%, 68.5%, 70.3%, 85.5%, and 42%, respectively. Moreover, administrative data were lacking in 31% of cases. There was almost 100% failure to document a communication note. The authors observed severe deficiencies in the documentation of death pronouncement. Key Words: Death pronouncement, Paediatric patients, Clinical tests, Paediatric residents, Intensive care unit.