death

Question 1

defining death

Answer 1

Irreversible loss of cerebral function with brain-stem death

Spontaneous respiration cannot occur and circulation will cease
Survivable ( reversible) states excluded :
Profound coma ( biochemical – drugs – phenobarbitone)
Profound – coma ( physiological – hypothermia) – can reverse this

Question 2

what is a TEP form

Answer 2

A TEP form is a way of your doctor recording your individual treatment plan, focusing on which treatments may or may not be most helpful for you

whether you resus or not

Start by cpr until you find a TEP form , if in doubt start CPR
You can easily reverse it

Question 3

what do you need to do to certify death

Answer 3

Pulse
Heart sounds
Breathing: mouth and chest
Pupils (reactivity to light)
(and potentially corneal reflex, deep pain response, trucking in retinal vessels)
Consider hypothermia/drugs

Start by asking if they can do something for you talk to them, close curtains, then give a painful stimulus , severe orbital pressure trapezius squeeze used over it
Then go onto eyes – pupillary response a - nd reflexes- cencile purpura
Now listen to their heart for 2 minutes continuously – wait 10-15minutes after so that heart has completely stopped beating. Also meant to feel for carotid pulse for 2 minutes
Breath sounds for 2 minutes
Thank you mr smith ill leave you to sleep now

John smith NHS number , hospital number DOB
Vertification of death - h richardsion Docotr/medical student etc
Documentation  no response to stimulus, apnoiec 2 mintues, absent heart sounds 2 monitues, no crotid pulse 2 minutes, pupils bilateraly fixed and dilated

Death confirmed 2.3.22 17.43
May she rest peacefully

H richardsion
GMC 1223456

2.3.22 – 17.43

Question 4

Peripheral chemoreceptors (in aortic and carotid bodies) respond to PO2, metabolic acidosis (& PCO2)

Answer 4

Central chemoreceptors are main control system, responding to PCO2 via changes in CSF pH

Question 5

is being buried or cremation 2 parts

Answer 5

cremation

Question 6

MCCD

Answer 6

medical certificate of cause of death

Question 7

the coroner is a Judicial officer who investigates sudden, violent, suspicious or unnatural deaths

what are the reasons for referral to the coroner

Answer 7

Not seen by a doctor within 14 days before death

The death is considered suspicious/unnatural/violent

The death may be due to an accident, self-neglect or neglect on the behalf of others

The death is/could be due to the deceased’s prior employment

The death may be due to an abortion

The death occurred during an operation or before recovery from anaesthetic

The death occurred during or shortly after a period of police custody

The death may be suicide

Unknown cause of death

Sudden or unexpected death

Question 8

completing a death certificate

Answer 8

I a Immediate cause of death
b Disease/condition leading to Ia
c Disease/condition leading to Ib

II Disease/condition contributing to death but not causing it – made them more frail or susceptible to death but has not killed them and is not mentioned in 1

Causes of death list
Cant put organ failure so you could say acute MI – but circulatory failure as the mode