DEATH AND SIGNS OF DEATH

ABIOLA MUBARAK MOHAMMED

OUTLINE

INTRODUCTION TYPES OF DEATH CAUSES OF DEATH STAGES OF DEATH PROCESS OF DEATH SIGNS OF DEATH DEATH CERTIFICATE CONCLUSION

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INTRODUCTION

Death is the termination of all biological functions that sustain a living organism

The word dead comes from old English dead, which in turn comes from proto-Germanic *dauthuz. This comes from the proto-Indo-European stem *Dheu meaning the “process, act, condition of dying”

150,000 people die around the world each day 3

INTRODUCTION

In modern times, death has been thought to occur when the vital functions cease—breathing and circulation (as evidenced by the beating of the heart). This view has been challenged, however, as medical advances have made it possible to sustain respiration and cardiac functioning through mechanical means. Thus, more recently, the concept of brain death has gained acceptance. In this view, the irreversible loss of brain activity is the sign that death has occurred

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INTRODUCTION Even the concept of brain death has been

challenged in recent years, because a person can lose all capacity for higher mental functioning while lower-brain functions, such as spontaneous respiration, continue. For this reason, some authorities now argue that death should be considered the loss of the capacity for consciousness or social interaction.

The sign of death, according to this view, is the absence of activity in the higher centres of the brain, principally the neocortex.

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TYPES OF DEATH

CLINICAL/SYSTEMIC/SOMATIC DEATH BIOLOGICAL/MOLECULAR DEATH

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CAUSES OF DEATH

Causes of Death

Natural

Senescence

Unnatural

Homicide Accidental death Suicide

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SIGNS OF IMPENDING DEATH1. Loss of appetite2. Excessive fatigue and sleep3. Increased physical weakness4. Mental confusion or disorientation5. Laboured breathing (Cheyne-Stokes & Death rattle)

6. Social withdrawal7. Changes in urination habit8. Swelling in the feet and ankles9. Coolness in the tips of the fingers and

toes10.Mottled veins

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DEATH AS A PROCESS Thanatologists (those who study the

surroundings and inner experiences of persons near death) have identified several stages through which dying persons go:

1. Denial and isolation (No, not me!); 2. Anger, rage, envy, and resentment

(Why me?); 3. Bargaining (If I am good, then can I

live?);4. Depression (What's the use?); and 5. Acceptance.

.

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DEATH AS A PROCESS (cont’d)LIFE For normal functioning, all cells of

the body require oxygen. If oxygen is not provided, death may appear with in 4-5 minutes (insult to cerebral tissue)

BRAIN This is the most susceptible tissue to

anoxia (absence of oxygen)10

DEATH AS A PROCESS (cont’d)Eventually all cells will die if deprived

of oxygen.The brain and heart are the most

sensitiveTIME IS CRITICAL 0-1 min: cardiac irritability 0-4 min: brain damage not likely 4-6 min: brain damage possible 6-10 min: brain damage very likely > 10 min: irreversible brain damage 11

DEATH AS A PROCESS (cont’d)The Terminal States These are the boundary lines

between life and death. The stages include

a) Pre-agonyb) Agonyc) Clinical death (reversible injury)d) Biological death (irreversible injury)

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DEATH AS A PROCESS (cont’d) Pre agony – falling of arterial pressure,

loss of consciousness, decrease of metabolism

Agony – further fall in the blood pressure, cessation of breathing and a sudden return to life (the surge – last spark of life), steep reduction of all vital functions after

Clinical – reversible cessation of vital functions of the brain, heart and lungs. Life ceases in the body but persists in component parts of the body

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DEATH AS A PROCESS (cont’d) Biological – this is the death of the

tissues and cells individually. It signifies the loss of life in the component parts of the body

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SIGNS OF DEATH

ImmediateLoss of vital

functions of the brain

Permanent cessation of circulation

Permanent cessation of respiration

Late

Changes in skin

Changes in muscles

Ocular changes

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SIGNS OF DEATH (cont’d)

IMMEDIATE Loss of vital functions of the brain

(cerebral cortex & brain stem) Flat Electroencephalography (EEG) Cessation of circulation through the retina Lack of responsiveness to internal and

external environment No muscular movement with generalized

flaccidity Absence of all brainstem reflexes

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SIGNS OF DEATH (cont’d)

CESSATION OF CIRCULATION If heart sounds are not heard for a continuous

period of 5 min, cessation of circulation is diagnosed

Absence of radial or carotid arteries pulsations Flat Electrocardiography

CESSATION OF RESPIRATION It must be complete and continuous to

constitute a proof for death. Absence of air-entry may be demonstrated by

auscultation for 5 min

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DEATH CERTIFICATE

This is a document issued by a medical practitioner certifying the deceased state of a person or popularly to a document issued by a person such as a registrar of vital statistics that declares the date, location and cause of a person’s death as later entered in an official register of deaths

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DEATH CERTIFICATE

In Nigeria, the National Population Commission is saddled with the responsibility of registering and issuing of death certificate in Nigeria

A death certificate is issued to serve as proof of registration of death

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DEATH CERTIFICATE

NATURE OF A CERTIFICATE Bio data of Deceased Name of person reporting death Date & Time of death Cause of death (primary & secondary

causes) Date of registration Name of certifier Signature of Registrar

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DEATH CERTIFICATE

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Conditions for Registration of Death in Nigeria The death must be registered by the registrar of

birth in the are where the death took place An applicant must have proof of death An applicant must be a blood relative of the

deceased Death must be reported within 7 days from the

date of death Death reported after 30 days from date of death

and within 12 months may be registered at a fee as may be prescribed by the commission

Death reported after 12 months from date of death can only be registered with written authority of the deputy Chief Registrar 22

“All interest in disease and death is only another expression of interest in life.”

-Thomas Mann (1875 - 1955)

The Magic MountainMicrosoft ® Encarta ® 2009. © 1993-2008 Microsoft Corporation. All rights

reserved

REFERENCES

Frederick, Calvin J. "Death and Dying." Microsoft® Encarta® 2009 [DVD]. Redmond, WA: Microsoft Corporation, 2008.

“How to Get a Death Certificate in Nigeria” NF author www.nigerianfinder.com/how-to-get-a-death-certificate-in-nigeria/

Autopsy Pathology. Dr Umar Mohammed. Morbid Anatomy and Forensic Medicine UDUSOK

Medical Theory of Death. Probable and Absolute Signs of Death –Budko A. Yurievna

Signs of Death. www.linkis.com/blogspot.com/7yi98

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