Death Flashcards
cellular death
the cessation of respiration (utilisation of oxygen) and the normal metabolic activity in the body tissues and cells.
somatic death
the individual will never again communicate or deliberatly interact with the environment, the individul is irreversibly unconcious and unaware of both the world and their existence
Academy of Medical Royal Colleges code of practise for the diagnosis of death
death entails the irreversible loss of those essential characteristics which are necessary to the existence of a living human person and, thus, the definition of death should be regarded as the irreversible loss of the capacity to breathe
report certain categories of deaths
to the coroner before they can be registered
deaths which may be due to accident (all deaths involving any form of injury or poisoning must be referred to the coroner) suicide violence neglect (by self or others) industrial disease deaths for which the cause is not known Deaths occurring during an operation before full recovery from an anaesthetic deaths occurring in/shortly after release from, police or prison custody
Who should certify the death?
When a patient dies it is the statutory duty of the doctor who has attended in the last
illness to issue the MCCD. There is no clear legal definition of “attended”, but it is
generally accepted to mean a doctor who has cared for the patient during the illness that
led to death and so is familiar with the patient’s medical history, investigations and
treatment. The certifying doctor should also have access to relevant medical records and
the results of investigations.If no doctor who cared for the patient can be found, the
death must be referred to the coroner to investigate and certify the cause.
The MCCD is set out in two parts
Cause of death the disease or condition thought to be the underlying cause should appear
in the lowest completed line of part I
I
(a) Disease or condition leading directly to death
(b) other disease or condition,if any, leading to I(a)
(c) other disease or condition,if any, leading to I(b)
II
Other significant conditions Contributing to death but not related to the disease or condition causing it
underlying cause of death,
a) the disease or injury which initiated the train of morbid events leading directly to death
b) the circumstances of the accident or violence which produced the fatal injury
livor mortis
blood collection after death
immediately after death, blood is unfixed and will still move; becomes fixed after few hrs to 8-12 hrs,
only up to 6 hrs after death can lividity be altered by moving the body, after 6 hrs lividity is fixed as blood vessels begin to break down
rigor mortis
summary
2-6 hrs after death, starts with eye-lids, jaw, neck
6-10 hrs rigor spreads to the other muscles
onset more rapid in cold
onset more rapid if just done hard physical work
onset varies with age, sex, physical condition, muscular build
24-48 hrs secondary laxity
many infant/child will not have perceptible rigor mortis
cadaveric spasm-immediate onset rigor which can happen if muscles depleted of oxygen just prior to death
rigor mortis;
warm body
not stiff
dead < 3 hrs
rigor mortis;
warm body
stiff
dead 3-8 hrs
rigor mortis
cold body
stiff
dead 8-36 hrs
rigor mortis
cold body
not stiff
dead > 36 hrs
Putrefaction /
what happens to the body in absence of embalming or rapid cremation
greenish skin discoloration on the R lower Abd 2-3 days after deathThis coloration
spreads over the abdomen, chest, and upper thighs
putrid odor; the smell, rather than the sight, is the most distinctive thing about a putrefying body.
7 days after death; most body discoloured, blood tinged blisters, skin loosens (skin slip-top layer comes off)
7-14 days after death; abdomen+scrotum+breasts+tongue swell, eyes bulge, bloody fluid seeps out of mouth& nose
3-4 weeks; hair+nails+teeth loosen, internal organs rupture and liquefy
uterus and prostate usually still present after 12 months, resistant to decomposition
TOD by body temperature
37.5C - 1.5C/hr until ambient temperature
