Lecture 4 - What Happens When A Person Dies? Flashcards
What decisions need to be made when emergency service discover an individual?
Determine whether individual is dead or whether medical intervention is appropriate
Is there a DNR order in place
When may the police be involved with community deaths?
When death is suspicious, cant be explained, children, Next of Kin (NOK) not contactable, accidents , RTCs
What is the legal requirement of GPs ad medical doctors in hospitals if an individual is found deceased and has used services in the last year?
GP must diagnose the mos likely cause of death to the best of their knowledge and belief
What are the 8 steps to verify a death?
Identification
General inspection (signs of life? Respiratory effort?)
Verbal stimulus
Painful stimulus
Pupiliary light reflex
Carotid pulse
Heart sounds
Breath sounds
How long do you check for signs of life?
5 mins
What are the issues when a person dies in community and hospital?
Getting someone there to verify the death (community/hosptial)
Moving the body (community)
What is the purpose of death certification?
Identify disease leading to mortality
Statistical information on deaths by underlying cause
Monitor health of the population
Identify areas where public health need to prioritise and evaluate interventions
Medical research and health services
What is the role of the Medical Examiner?
Scrutinises medical information in regards to patients deaths
They safeguard public by ensuring independent scrutiny of all non coroner examined deaths
They direct appropriate deaths to the coroner
When are deaths referred to the coroner?
Children
Trauma
Violent deaths
Poisonings, Drugs, Alcohol
Industrial Diseases
Unnatural deaths
Dead in hospital 24hrs following admission
Any medical intervention within last 12 months
What quality of care improvements does the Medical Examiner provide?
Discuss and answer any questions about the death with the Next Of Kin (NOK)
Improve quality of death certification (agree cause of death and increase accuracy)
What is the role of the Coroner?
Investigate the deaths that don’t seem natural, violent, or where cause is unknown
What do the coroners investigate?
Who is dead?
Why is this person dead?
When did they die?
How did they die?
What can a coroner decide?
No further investigations needed
Request a post-mortem examination (PM)
If the death is determined natural, they release the body and register the death
What is an inquest?
Finding/establishing facts following a post mortem
Not to attribute blame or liability just to establish facts
What are some examples of inquest verdicts?
Natural causes
Accident
Suicide
Unlawful or lawful killing
Industrial disease
Open (insufficient evidence)
Narrative (story of death)
What is a post mortem?
Examination after death
What normally happens with a hospital post mortem?
Relatives of deceased consent for PM is gained
Cause of death should already roughly be known
Seek implicit question/test a hypothesis E.g:
Did the antibiotics work effectively?
What was the cause of the haemorrhage?
What happens in a coroners post mortem?
Full history and additional information reviewed
Confirm identity and external examination
Non Invasive (CTPM scan) then invasive if necessary
How to formulate a cause of death on a Cause of Death form?
Cause of Death should be the top line 1a)
Other disease or condition that caused 1a) should be written in 1b)
Condition that caused 1b) written on 1c)
Which line should the disease/condition that directly caused the death be written on in a Cause of Death form?
TOP Line 1a)
Where should the condition that is thought to be the underlying cause of death be written of a Cause of Death form?
Last completed line of section 1
This will be the condition that will be have thought to have directly or indirectly be the cause of death
