The Ships Captain’s Medical Guide: Care for the Dying and the Dead

There is no stage in dying when nothing more can be done.
There always remains the task of protecting the patient from pain.
There should be people around to care for him.
Be sure to respect his dignity as a human being.
Never consider anyone to be dead until you and others agree.
Check breathing, pulse, eyes, and for blue in the skin.
Put your ear on the left side of the chest near the nipple and listen.
Ensure that the pupils do not respond to light.
Be aware that mistakes have been made, so check carefully.
Drugs or hypothermia are viable alternatives.
Investigate the circumstances surrounding the apparent death.
Do not be too hasty in arriving at a conclusion.
It is important to establish the reasons for the death.
Begin by choosing between disease and injury.
Look for any extant medical records for clues.
If circumstances are suspicious, evidence must be preserved.
It is usually possible to retain the body for a period of time.
Photographs are useful, especially those of apparent anomalies.
Strip the body of all clothing, without cutting, and preserve it.
Note vaccinations, tattoos, and external signs of disease.
To best preserve the body for examination and land-side burial, wash and dry it thoroughly.
Comb out and part the hair and give attention to fingernails.
Straighten the arms and legs and interlock the fingers over the thighs.
Empty the bladder by firm pressure over the lower abdomen.
Only in the most exceptional circumstances might you dispose of the body at sea.
If you must, sew it into a weighted shroud of very strong material.
It must ensure rapid sinking and permanent submersion.
Slits must be prepared in the shroud to allow gases to escape and prevent flotation.
Burial should not take place in soundings in any part of the world.
After preparation, place the body on an improvised platform on the ship’s side rail.
If seas are rough, ensure against accidental slippage: the body should slide cleanly into the sea.
Record the event in the official log with time and precise coordinates.

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