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Death, Types of Death and Brain death
1.
2. Thanatology
It is a process rather than an event.
clinical death biological death
brain death cellular death
( lack of oxygen)
3. According to registration of births and deaths
act,sec-2(b) defines death as permanent
disappearance of all evidence of life at any time
after live birth has taken place
2 types of death
Somatic death or systemic death
Molecular death
4. It is the complete and irreversible stoppage of the
circulation,respiration and brain functions (bishop’s tripod of
life) but there is no legal definition of death.
It is important in resuscitation and organ transplantation
As long as circulation of oxygenated blood is maintained to the brain stem
,life exists.
Whether the person is alive or dead can only be tested by withdrawal of
artificial maintenance .
A person who cannot survive upon withdrawal of artificial maintenance is
dead
5. It means the death of cells and tissues individually , which
takes place usually one to two hours after the stoppage of
the vital functions .
Individual cells will live on their residual oxygen for a
variable time after the circulation has stopped , depending
on the metabolic activity of the cell .
Nervous tissues die rapidly,the vital centres of the brain
in about 5 minutes but the muscles live up to one to two
hours
Anoxia
6. •ANOXIA-according to Gordon the stoppage of vitals depend upon
tissue anoxia
•Anoxia : lack of oxygen
•Anoxic anoxia
•Anaemic anoxia
•Stagnant anoxia
•Histotoxic anoxia
7. ANOXIC ANOXIA
In this oxygen cannot reach the blood because of lack
of oxygen in the lung
This occurs from breathing in a contaminated
atmosphere or from mechanical interference with the
passage of air into the respiratory tract.
8. ANAEMIC ANOXIA
In this type oxygen carrying capacity of the blood is
reduced
Like in poisoning by
Carbonmonoxide,nitrates,chlorates,coaltar derivatives
and acute massive haemorrhage,
9. STAGNANT ANOXIA
In this type impaired circulation results in a reduction
of oxygen delivery to the tissues
Eg.Heart failure,embolism and shock
10. HISTOTOXIC ANOXIA
In this type the enzymatic process by which the oxygen
in the blood is used by the tissues are blocked
Eg.acute cyanide poisoning
11. •Normal levels of oxygen in arterial blood is 90-100mmHg
at 30 years and 65-80mmHg at 60 years and above
•Reduction to 60 mmHg results in hypoxia.At
40mmHg,there is severe hypoxia and death may occur at
20 mmHg
12. Historically concept of death was that of “heart and respiration
death”,however have changed this medically in favour of a new
concept “brain death” that is irreversible loss of cerebral function.
It is of 3 types
Cortical/cerebral death
Brain stem death
Whole brain death
13. CORTICAL DEATH
Cerebral death with an intact brain stem.
This produces a vegetative state in which respiration
continues,but there is total loss of power of perception
by the senses.
This state of deep coma can be produced by cerebral
hypoxia, toxic conditions or widespread injury.
14. BRAIN STEM DEATH
Where the cerebrum may be intact,though cut off functionally
by the stem lesion.
The loss of vital centres that control respiration and of the
ascending reticular activating system that sustains
consciousness,cause the victim to be irreversibly comatose and
incapable of spontaneous breathing
This can be produced by raised intracranial pressure,cerebral
oedema,intracranial haemorrhage.