How Doctors Know When Someone Is Dead?

Diagnosing death may not be as easy as it sounds. It is possible that the person may just be unconscious or has entered a state of coma. Also, there have been various cases where people have literally been back from the dead. For example, the phenomenon of auto resuscitation is widely known in the medical fraternity. In such cases, the heart first stops and then starts beating again after a minute or two. Although rare, such cases have been witnessed by various doctors.

Such factors make the job of diagnosing death a big responsibility for doctors. There has been various news stories wherein people pronounced dead have woken up hours later or found breathing. Such things require doctors to take adequate precautions to avoid making a false death diagnosis. To ensure there are no doubts, doctors usually use multiple methods to certify death. Here are some methods that allow doctors to know when someone is dead.

Identifying the cause of death

To get a better idea of the situation, a doctor first tries to find out the probable cause of death. It could be various factors such as external or internal injury, blood loss, infection, any illness, old age, etc. Once a doctor gets a better idea of why the person has died, it becomes easier to diagnose death.

Methods for diagnosing death

1. Absence of heartbeat and pulse – The doctor checks to see if the patient has a pulse. Using a stethoscope, the doctor also tries to identify any sounds of a heartbeat. An electrocardiogram (ECG or EKG) is also used to check for any type of electrical signals from the heart.
2. Absence of respiration – This is done to check if the person is breathing. Sometimes, the breathing may be very shallow. This may make it difficult for the doctor to take a decision.
3. Brain death – Sometimes, the patient’s heart and respiratory system may still be functioning. However, they may have experienced head injury or infection, which may have caused brain death. Doctors check for this by shining a light into the eyes. If there is no change in the pupil, it indicates that the patient is brain dead. An electroencephalography (EEG) test can also be performed to certify brain death.
4. Pain stimulus – This is used by doctors to understand the condition of a patient who may be unconscious. This method is used when the patient is not responding to normal stimuli. If the patient’s brain is still active, it will induce a reflex action in response to the pain stimulus. Various methods of pain stimulus can be used such as sternal rub, supraorbital pressure, mandibular pressure and trapezius squeeze.

Doctors rely on not one but multiple methods to diagnose death. Not doing so can lead to a false death diagnosis. This appears to be the reason why some people come back from the dead. As a rule, doctors should wait a few minutes after examining the patient. If there are any doubts, the person needs to be reexamined. This approach will ensure that the diagnosis is 100% correct.