Permanent and irreversible stoppage of
respiration, circulation and brain function, the so called ‘Tripod of life’
- Generally the practicing doctor diagnoses death by
auscultation; but, this can be difficult in cases of excessive fat,
emphysema, apex beat below the rib, poorly beating heart and shallow
diaphragmatic respiration. All these conditions dampen conduction of heart
sound to body wall.
- Diagnosis of recent death is also very difficult
whenever the death of the person has not been observed. When a doctor is
called to certify a patient ‘as dead’ that is brought by ambulance, he
must insist that the body be removed to a well lit room where he can carry
out his examination.
- Even though the condition is satisfactory, there can be
error during examination. The signs of life can be detected by special
methods like oscilloscope, ECG and EEG etc.
- It can never be assumed that attempted resuscitation is
pointless. On the other hand, resuscitative measures should always be
continued for half an hour.
- In cases of electric shock, asphyxia particularly
drowning and drug overdose, resuscitative measures should always be done
- There is segmentation of blood in retinal blood vessels
in ophthalmoscopic examination. If still there is little doubt, the
patient should be taken to intensive care unit for further investigation
of heart and brain function.
(Ref: Dr. PC Dikshit Head (MAMC) MD
LLB, Textbook of Forensic Medicine, Peepee Publisher)
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