Causes of Death Flashcards
How do you physically confirm death?
Pulse, heartbeat, pupil dilation, respiration
If you are not able to identify whether a person is dead or not who is called to investigate?
The procurator fiscal (or coroner elsewhere?
When can a death certificate be issued?
Only a GMC registered medical doctor can issue certificate, relatives take death certificate to registrar’s office, has to be done within 8 days (in Scotland)
What happens if cremation is opted for?
A cremation certificate is required
If not cremated what happens to the body?
It is buried
What certificate is given after the body is dead?
Certificate of disposal is given
Who is the proscurator fiscal?
Prosecution of crimes
Investigation of deaths, expected and unexpected
Not involved with the most serious crimes (rape and murder)
What do coroners do?
Hold inquests (Scotland hold FAIs): conducted entirely by coroner, sits with jury for deaths at work or in custody, 1 of 9 verditcs will be determined Has to pass onto CPS (crown prosecution service) if criminal case
What are coroners?
->850 years, old system
Limited to investigation of sudden and unexpected deaths
No role in investigating/ prosecuting crime
Additional role in investigating deaths where person had not been seen by doctor in past 14 days
What are the options for verdict of death?
- Natural Causes: heart disease, illness
- Suicide
- Accident/ misadventure
- Industrial disease: e.g. asbestos related lung disease
- Drug dependency: e.g. heroin
- Lack of care: e.g. in care homes
- Lawful killing; e.g. suspected terrorism, reason to suspect person would cause damage to others
- Unlawful killing: against the law, murder
- Open: undecided
What are the causes of death in Scotland?
- Natural Causes
- Alcohol abuse
- Suicide
- Accident
- Drug abuse
- Homicide
- Other
What is cardiovascular disease classified as when it is a cause of death?
Natural disease
What causes cardiovascular disease?
heart disease
coronary artery disease: end artery (supplies heart muscles) results in myocardial infarction, chronic electrical instability, amenable to bypass surgery
When does cardiovascular disease begin?
Formation of plaques begins at 2 years old, much of it arises from genetics
What is the process of cardiovascular disease?
micro damage → inflammation of blood vessels → monocytes are attracted to injury, become macrophages → become foamy → platelets arrive to try repair → platelets build up and become fibrous
What is Pulmonary Thromboembolism (PTE)?
Involves veins, particularly in lower limb
Related to deep vein thrombosis
Embolism moves up to the lungs
What are risk factors in getting PTE?
Recent surgery: bed rest means less movement of lower limbs, blood clots can form
Immobility: due to illnesses, joint replacement, elderly, obesity
Pregnancy
Malignancy
Varicose veins: more common in women
Elderly: less mobile
Oral contraceptive: combined pill has more risk
Long haul flights
What are the two types of cerebral haemorrhage?
Intra-cerebral
Subarachnoid
What are the two causes of a stroke?
Cerebral haemorrhage
Cerebral infarct
What are some examples of sudden death strokes?
Ischaemic heart disease
Hypertensive heart disease
PTE
What are some less rapid deaths?
Myocardial infarction
Rupture aortic aneurysm: very low chance of survival
Acute athsma
Epilepsy
What are some examples of suspicious deaths?
Homicide
Poisoning
Fire related
What injuries are caused in fire related deaths?
- red blistering if skin with paler marginal zone
- more severe: skin is stiff and leathery
- can be completely charred/ destroyed
- bone my become blackened or brittle
- muscle contractures – ‘pugilistic attitude’ - all flexor muscles contract
- skin splits, especially at extensor surfaces
What percentage of body surfaces burns are fatal?
30-50%
What do most people in fire related deaths actually die from?
Secondary problems like dehydration or infection
What are first degree burns?
Superficial layer or epidermis is damaged e.g. sun burn
What are second degree burns?
Full thickness, both epidermis and dermis are damaged, sometimes goes through subcutaneous fat
What are third degree burns?
Complete destruction of all three layers, epidermis, dermis and subcutaneous fat, down to bone
