Death diagnosis
The doctor's duties are not limited to the treatment of patients, but also several other duties. One of them is the diagnosis of death, and if there is any unnatural death, it is reported to the relevant entity. When a person loses consciousness, the doctor should check the victim to diagnose the condition and do the necessary things. If the victim has died, the doctor is obliged to declare that the person has died. If there is no doctor at the scene, even a layman must handle this situation. Here, it is important to understand the basic techniques of first aid and death diagnosis.
We all know that death is the end of biological function of an organism. It is the ultimate in every creature on earth. Once we are born, one day our soul will leave the physical body forever. Scientifically, death is due to the complete and irreversible stopping of important functions of the brain, heart and lungs.
Stage of death
Death occurs in two phases:
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1.Somatic, systemic or clinical death
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2. Cell or molecular death
In somatic cell death, although the whole life in life stops, it can persist in different body parts, organs, tissues and cells. Body cells can survive for different periods and can respond to a variety of chemical, thermal and electrical stimuli. The survival of the cells depends on the amount of oxygen required. When cells and tissues die, it is considered a molecular death. Typically, molecular death is completed within 3 to 4 hours of somatic cell death. However, according to the usual statement, death means physical death.
What causes death?
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Regardless of the remote cause, a person dies due to the failure of any organ such as the brain, heart, and lungs. This is called the near cause of death. Remote causes may be due to injuries, infections, blood loss, poisoning, drugs, cancer, malnutrition, dehydration, hunger, etc. Sudden death may be due to cardiovascular, respiratory, central nervous system, abdomen, endocrine, iatrogenic, etc. Special cases of child failure, malnutrition, disease, accident, injury, predation, suicide, murder, war, and some uncertainty s reason.
Signs of death
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Signs of death can be studied under three headings: immediate signs, early signs and late signs.
Immediate signs: These signs indicate physical or clinical death.
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- Insensitive [feeling loss, movement and reflection]
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- Loss of EEG rhythm
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- Stop the cycle by steady ECG and no breathing indication.
However, in the case of prolonged fainting episodes, vagus nerves, epilepsy, anesthesia, electric shock, etc., symptoms such as loss of feeling, exercise, respiratory loss, pulse and heart sound may also occur. Here, these signs cannot be considered a 100% guarantee. However, they can only be considered dedicated if the 5 minute continuous loss of EEG rhythm is associated with a 5 minute flat ECG.
Early signs: These signs indicate molecular or cell death, which lasts about 12 to 24 hours.
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- Algor motris: After death is the cooling of the body.
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- Post-mortem lineage: discoloration after death. It starts in 1 to 3 hours and is repaired in 6 to 8 hours.
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- Strict death: stiff body after death. It starts 2 to 3 hours after death and takes 12 hours to develop, lasts 12 hours, and takes 12 hours to completely disappear.
Late signs: These signs represent the breakdown or decay of the body, or in some cases, the body is modified into fat cells or mummies. Late signs appear after about 24 hours. Corruption of the body manifests itself as a green discoloration that occurs 12 to 24 hours after death. The marble pattern is a mark on the skin that appears after 12 hours and becomes prominent 36 to 48 hours after death. He also began to appear because of corruption.
brain death
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It is the irreversible end point of all brain activity, but the brain stem is still working. When brain death occurs, the victim can remain viable by maintaining heart and lung function with the help of complex instruments and some medications. By keeping oxygenated blood supplied to the brainstem, the body can survive. When the brainstem also stops working, it is considered an important indicator of death.
Stop animation
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This situation is also known as the death of an apprentice. Here, the important functions of the body are so low that they cannot be detected by conventional clinical examination methods. Pausing animations can last from a few seconds to a few minutes. This condition can be noticed in obvious drowning, neonatal, anesthesia, brain concession, electric shock, heat stroke, hypnosis, excessive barbiturate, opium, deep shock and so on. Recovery techniques can resume pause animations.
Death diagnosis
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It is not easy to diagnose death immediately after death, especially those who are inexperienced. Rarely, due to suspended animation, excessive sedatives and hypnotics, hypothermia, alcohol toxicity, etc., some difficulties may arise. When you are asked to make a diagnosis of death, you should handle this situation subtly. The room where the victim rests should not be overcrowded. Only a few people are allowed to appear on the site. There should be proper light, air in, no noise and other disturbances.
Check: The check should be completed in a few seconds, don't waste too much time. Look at the victim from head to toe and look for any body movements such as the chest, abdomen, nose, etc. Then feel the radial pulse. If you don't feel it, please go to the carotid artery to beat the thyroid cartilage later [do not press the two carotid arteries at the same time, only feel that there is not much pressure on one side]. Then pick up the stethoscope and listen to the heart and breath sounds of the chest. If you have heart and lung failure, perform mouth-to-mouth or mouth-to-mouth breathing and an external heart massage to restore your heart and lungs.
If there is no response after cardiac resuscitation, the doctor is obliged to confirm the victim's death. Respiratory arrest was confirmed again by holding the stethoscope in the chest/throat for 5 minutes, and cardiac activity was stopped by holding the stethoscope in the anterior region for 5 minutes. A feather test can be performed to see any airflow through the nose. Open the eyelid and move the head from side to side. If the eyeball is fixed and moves with the head, it is a sign of death.
When light enters the eye, take a clinical torch and check for eye dilation. When the body dies, the pupils expand and the cornea loses its luster appearance. But it may not be immediately understood after death. For those with eye lesions that are particularly associated with diabetes, these findings can be confusing. When a person dies, pale will appear in a few minutes. After scalding the victim's nails, look for capillary fillings. In the corpse, no capillary refill was seen.
If in doubt, ECG and EEG monitoring can be performed. A 5-minute flat ECG is an acceptable evidence of death. No brainwaves confirmed death in five minutes. However, EEG and ECG do not need to provide a death certificate because in most cases a death diagnosis can be made through a clinical examination. However, these tests have a confirmed value.
Legal aspects of death
The legal aspects of death vary from country to country. There are differences of opinion regarding the definition of brain death. However, according to modern thinking, if a person cannot pick up and survive spontaneously when withdrawing artificial means, he will be presumed to die. Irreversible brain damage can be confirmed by flat EEG.
If there are any signs of unnatural death or death, the cause of death must be confirmed by medical legal anatomy. Unnatural deaths can be accidents, suicides, homicides, and even natural deaths, but accidents and occur in both cases. All unnatural deaths should be subjected to a medical legal autopsy to determine the exact cause of death, the time of death, and the location of the body at the time of death. It is the doctor's responsibility to inform the authorities of any unnatural deaths when he appears.
Orignal From: Diagnosis of death
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