What must you assess to pronounce a death in the field?

To pronounce a death in the field, it is essential to assess the apical pulse for 60 seconds. This step is critical because confirming the absence of a heartbeat is a definitive indication of death. The apical pulse represents the heart's function directly and checking it over a full minute ensures that any transient pulses or irregular heartbeats are not mistakenly identified as a sign of life.

While other assessments such as respiration, capillary refill time, and pupil response can provide supplementary information about a patient's condition, they are not definitive indicators of death on their own. Respiration may stop for brief periods, and capillary refill can vary in certain circumstances, notably in cases of hypoperfusion. Pupil response can also be influenced by various factors, including drugs or neurological conditions, making it less reliable as the sole criterion for determining death. Thus, the clear assessment of the apical pulse over a full minute is the most reliable and standard practice in this situation.