Diagnosis Of Death

Question 1

MLI od somatic death

Answer 1

1. Legal definition of death depends upon the diagnosis of somatic death
2. Isssuing a death certificate depends upon clinical death

Question 2

Mention the tenants of diagnosis of somatcic death

Answer 2

1. Cessation of circulation: pulsation, BP, heart beats and Flat ECG in all leads.
2. Cessation of respiration: apnea, ABG with severe hypoxia and hypercapnea
3. Cessation of brain function: deep unresponsive coma, no movemnet, tremors or fasciculation, absent brain stem reflexes, flat EEG.
4. Supporting evidence: early signs of PM changes, lab findings incosistent with life.

Question 3

MLI of molecular death

Answer 3

Determining the proper timing for organ transplantation from a cadaver after diagnosis of somatoc death.

Question 4

Persistent vegetative state lasts for ….

Answer 4

Longer than 1 month

Question 5

Management of pesistent vegetative state

Answer 5

1. Prevent infections
2. Maintain patient physical state and avoid bed sores and cotractures
3. Provide balanced hydration and nutrition

Question 6

MLI of diagnosis of BS death

Answer 6

1. To permit withdrawal of mecahnical ventilator.
2. To prove the relation between the primary injury and death as the assailant may claim the the doctors caused death by switching off the entilator.
3. To allow harvesting of organs for tranplant
   1,3 ( n countries allowing that)

Question 7

Describe medical personnel involved in process of BS death diagnosis

Answer 7

1. Two medical practitioners (intensivist, neurologist, neurosurgeon) perform brain stem death tests twice and separately after an interval of at least 4 hrs.
2. Must be experts in their field.
3. At least one of them is consultant, junior doctors are not allowed.
4. The medical practitioner should have no previous relation to pt or relatives.

Question 8

MLI of diagnosis of death

Answer 8

1. Diagnosis must be accurate to avoid premature burial.
2. Death must be differentiated from suspended animation
3. Death should not be certified as natural if there is suspicion of accident, suicide or homicide as signs of violence on GE, sudden death occurring outdoors, young/middle-aged known to be healthy
4. Certification should be supported by cause and mechanism
5. Physicians in critical crae should rely on clinical death criteria for diagnosis. They shoukd not switch off life support if BS death is not legalized.

Question 9

Define sudden death, mention its most common cause and most underdiagnosed cause

Answer 9

Death of an apparently healthy person in less than 24 hours of onset of symptoms .
CVS causes are MC, PE is most underdiagnosed.