Death and the Medical Examiner Flashcards
Which of the following is the definition of death?
1 - Permanent loss of the capacity for consciousness and all brainstem function
2 - Permanent loss of the capacity to breath
3 - Permanent loss of the capacity for consciousness and all brainstem function and loss of ability to breathe
3 - Permanent loss of the capacity for consciousness and all brainstem function and loss of ability to breathe
Which of the following need to be checked and documents on a patient to confirm death?
1 - Absence of central pulse
2 - Absence of heart sounds
3 - Absence of respiratory effort and breath sounds
4 - Absence of neurological function
5 - Augmentation: ECG, echocardiography, arterial line trace
6 - Time of death at point when criteria fulfilled(legal time of death)
7 - all of the above
7 - all of the above
- respiratory effortand breath sounds needed to be taken over 1 minute and may need to be repeated after 5 minutes to confirm
When confirming death the absence of neurological function needs to be assessed. Which of the following is NOT part of this?
1 - reflexes
2 - dilated pupils
3 - no pupillary response to light
4 - no motor response to supra-orbital pressure
1 - reflexes
- supra-orbital pressure = pressure applied to bony bridge above the eye
Should CPR be performed on all patients without a central pulse and no signs of life?
- no
- should be performed on everyone, EXCEPT those with a DO NOT ATTEMPT CPR (DNACPR) is in place
Should CPR be performed indefinitely?
- no
- senior doctors call, but should stop of failure to return of circulation
- if CPR fails we need to verify the time of death
Typically do all patients who have died become hypothermic?
- no
- patients can be cold and alive
- phrase used is a patient is not dead unless they are warm and dead
If there is not an unnatural, traumatic death or someone under state detention, who would complete the medical certificate of cause of death (MCCD)?
1 - coroner
2 - medical doctor
3 - medical examiner
4 - any of the above
2 - medical doctor
- this is the doctor in charge of care within the last 28 days
If the cause of death was unnatural, traumatic, someone under state detention or the cause of death is unknown, who would complete the medical certificate of cause of death (MCCD?
1 - coroner
2 - medical doctor
3 - medical examiner
4 - any of the above
1 - coroner
Which of the following is a role that the medical examiners complete?
1 - review medical notes
2 - determine cause of death if possible and agree this on the medical certificate of cause of death (MCCD)
3 - ensure accuracy of MCCD to support national data & Public Health
4 - identify if coroner referral needed
5 - Communicate with relatives
6 - Provide medical advice to HM Coroner and Registrar
7 - all of the above
7 - all of the above
Which of the following deaths does NOT need to be referred to a coroner?
1 - unnatural
2 - violent
3 - cremated
4 - unknown cause
5 - state detention
3 - cremated
- state detention = prisons, sectioned in a mental health hospitals, immigration camps
Which of the following is NOT a requirement for the coroner to perform?
1 - who dies
2 - how they died
3 - what they died with
4 - when they died
5 - where they died
3 - what they died with
- coroners role is a procedural duty for independent public investigation
Coroners must have >5 years graduate experience in what?
1 - medicine
2 - judge
3 - lawyer
4 - pathologist
3 - lawyer
- typically doctors cannot be appointed, but there may still be a few around
During an inquest with a coroner, are the doctors or individuals involved in care required to defend themselves?
- no
- inquests are inquisitorial not adversarial
- no names are given, but public should know facts relating to public interest
At inquests by the coroner, are interested persons, typically the bereaved able to request documentation and ask questions during the inquest?
- yes
What % of deaths in the UK are referred to a coroner?
1 - 15%
2 - 30%
3 - 41%
4 - 66%
3 - 41%
