Citation

Klein A, Lach H, Puschel K. Notfall und Hausarztmedizin 2007; 33(6): 330-335.

Copyright

(Copyright © 2007)

DOI

unavailable

PMID

unavailable

Abstract

A 52-year old woman was found unconscious in her apartment. Next to her, several drug packages and a suicide note were discovered. Emergency medical personnel pronounced the woman's death after a thorough assessment. However, vital signs were noted by the undertaker during the body's transfer from the apartment floor to the coffin. The woman was given advanced live-support within further delay. She survived and subsequently recovered at a local hospital. This case study discusses the medical and legal neccessity for clear guidelines on the pronouncement of death in emergency medicine. It further introduces Hamburg's guidelines for the clear documentation of an, at least, 10-minute interval of asystole before death may be determined. In this context, the question remains as to the specific timeframe during which a potential reversal of the cardio-pulmonary arrest may be accomplished. In some circumstances, are even experts not able to pronounce death? Specifically, do well-defined signs of death exist, that either support or do not support the initiation and continuation of cardio-pulmonary resuscitation? Well-defined signs of death (livor mortis, rigor mortis, putrefaction) have been determined. However, if resuscitative efforts are unsuccessful, emergency medical personnel cannot wait for these signs to develop. The ability to pronounce death requires not only a comprehensive patient assessment, thorough education and extensive experience of the emergency medical personnel, but also proper equipment. Pronouncing death on the basis of a mere "glance" at the patient should be avoided.

Language: de

Keywords

Apparent death; Asystole in ECG; Emergency medical personnel; Pronouncement of death; Termination of resuscitation