This is a slide for 3rd year medical students all over the World .

1. DEATH

2. OBJECTIVES
Definition, types, moments of death
Signs of somatic death
Brain death
Suspended animation
Sudden death
Psychological ethical scientific issues of death
Duty of a doctor in relation to death
Death certificate
Death statistic and death audit

3. Def: Death is permanent and irreversible
cessation of functions of the three
interlinkrd vital systems of the body (the
tripod of life) namely the nervous,
circulatory and the respiratory systems

4. MODES OF DEATH:
Coma: Failure of the nervous system
Syncope: Failure of the circulatory system
Asphyxia: Failure to the respiratory system

5. Types of death
Somatic or systemic or clinical death
Molecular or cellular death

6. Somatic death: A person who can not pick
up spontaneously and survive after withdrawl of
artificial maintenance can be pronounced dead.
The person is dead but the cells are still alive.

7. Signs of somatic death
Insensiblity
Loss of voluntary movements
Cessation of respiration
Cessation of circulation
Cessation of nervous system functions

8. Brain death
Types of brain death:
Cortical or cerebral death
Brain stem death
Whole brain death

9. Cortical brain death-
In which respiration continues but there is total loss of
power of perception the senses due to cerebral hypoxia
Brain stem death-
Where cerebrum may be though cut off functionally by
the stem lesion due to raised intercranial pressure
Whole brain death-
Combination of cortical and brain stem death

10. SUSPENDED ANIMATION (APPARENT DEATH / DEATH
TRANCE)
Apparent death or suspended animation is the condition in which
signs of life aren’t found ,as the functions are interrupted for some
time or reduced to minimum though the person is alive

11. MECHANISM:
 Metabolic state is so reduced that requirement of individual cell for oxygen is satisfied
through the use of O2 dissolved in body fluids
 Freezing of body
 Severe drug poisoning of brain
 Activity of brain can completely stop in some cases and start again

12. TYPES OF APPARENT DEATH
oVoluntary suspension of animation
E.g. Practitioners of yoga can pass into a trance, death like in
character.
oInvoluntary suspension of animation
Lasting for a few seconds to half an hour or more

13. FEATURES OF APPARENT DEATH :
 All signs of life or vitality are seemed to be absent although the individual still remains alive
 Function of the circulatory , respiration or nervous system may not be perceived by conventional
method
 Person appears to be dead because of very feeble or minimum function of body system

14. This may occur due to:
 Drowning
 Electrocution
 Snake bite
 New born baby
 Cholera
 Shock
 After anesthesia
 Cardiac arrest
 Sunstroke
 Cerebral concussion

15. Diagonosis:
 Vigilant examination of the patient is required to observe any sign for life
 Repeated auscultation over a period longer than 5 minutes (at least twice)
 Investigation:
 ECG & EEG for cardiac and brain activity respectively
 Ophthalmoscopy should be done routinely
o DEATH IS CONFIRMED BY DETECTING
SEGMENTATION OF BLOOD COLUMN IN RETINAL
VESSEL

16. Medico-Legal importance of apparent death :
Death trance may be confused with death
Doctor may issue death certificate although the
person is alive
If resuscitated the person may return to life , but if
not resuscitated he/she may die.

17. RESUSCITATION:
The patient can be
resuscitated by cardiac massage or electric
stimulator
and artificial respiration.