WHO, WHAT, WHY? The Magazine answers... Woody has no lasting brain damage
WHO, WHAT, WHY? The Magazine answers... Woody has no lasting brain damage
Two-week-old Woody Lander "came back to life" half an hour after being pronounced dead by medical staff. So how do you diagnose death?
Two-week-old Woody Lander "came back to life" half an hour after being pronounced dead by medical staff. So how do you diagnose death?
His parents call him their "little miracle" and those in the medical profession say the case is "amazing".
His parents call him their "little miracle" and those in the medical profession say the case is "amazing".
Woody Lander - now a healthy 14 months old - was pronounced dead at Leeds General Infirmary after frantic attempts to save him by medical staff apparently failed. He had stopped breathing following a heart attack.
Woody Lander - now a healthy 14 months old - was pronounced dead at Leeds General Infirmary after frantic attempts to save him by medical staff apparently failed. He had stopped breathing following a heart attack.
He was handed to his parents so they could say goodbye but when nurses started removing tubes from his body he began "twitching". Staff tried again to resuscitate him, this time successfully starting his heart 30 minutes after he was pronounced dead.
He was handed to his parents so they could say goodbye but when nurses started removing tubes from his body he began "twitching". Staff tried again to resuscitate him, this time successfully starting his heart 30 minutes after he was pronounced dead.
The case highlights how it is not always as straight forward as it may seem to tell if someone has died. So how do you know if someone is dead?
The case highlights how it is not always as straight forward as it may seem to tell if someone has died. So how do you know if someone is dead?
WHO, WHAT, WHY? A regular feature in the BBC News Magazine - aiming to answer some of the questions behind the headlines
WHO, WHAT, WHY? A regular feature in the BBC News Magazine - aiming to answer some of the questions behind the headlines
Diagnosing death is about excluding all possible signs of life, say medical professionals. But as a body's organs and tissues do not die at the same time there can be doubt about the actual moment of death.
Diagnosing death is about excluding all possible signs of life, say medical professionals. But as a body's organs and tissues do not die at the same time there can be doubt about the actual moment of death.
In hospital someone is usually considered dead when there is no electrical activity from the heart or brain, say medics. But even these are not totally reliable indicators.
In hospital someone is usually considered dead when there is no electrical activity from the heart or brain, say medics. But even these are not totally reliable indicators.
Circumstances play a big part in each case, but hospitals have guidelines and procedures to follow in certain situations, says the Royal College of Physicians.
Circumstances play a big part in each case, but hospitals have guidelines and procedures to follow in certain situations, says the Royal College of Physicians.
These include the Glasgow Coma Scale (GCS), a standardised points system based on eye movements, spoken responses and other physical movement.
These include the Glasgow Coma Scale (GCS), a standardised points system based on eye movements, spoken responses and other physical movement.
Reversible
Reversible
All three things are tested and considered separately, then added together. The lowest possible score on the scale is 3, but even that is not definitive as it can indicate a deep coma as well as death.
All three things are tested and considered separately, then added together. The lowest possible score on the scale is 3, but even that is not definitive as it can indicate a deep coma as well as death.
When attempts are made to resuscitate someone after a heart attack - as in Woody's case - there are specific steps that must be taken. Eight reversible causes have to be checked one at a time before someone is pronounced dead.
When attempts are made to resuscitate someone after a heart attack - as in Woody's case - there are specific steps that must be taken. Eight reversible causes have to be checked one at a time before someone is pronounced dead.
These include:
These include:
Hypoxia
- lack of oxygen
Hypoxia
- lack of oxygen
Hyperkalemia
- high potassium
Hyperkalemia
- high potassium
Hypothermia
- low body temperature
Hypothermia
- low body temperature
Checking all the possible causes can take time, anything up to 45 minutes in extreme cases. The cut-off point for resuscitation - when a person is pronounced dead - is when all eight have been checked and there are still no signs of life.
Checking all the possible causes can take time, anything up to 45 minutes in extreme cases. The cut-off point for resuscitation - when a person is pronounced dead - is when all eight have been checked and there are still no signs of life.
"Sometimes death is diagnosed quickly and in other cases it can take much longer, usually when the person is in hospital and there is more equipment to try and restart the heart," says nurse and resuscitation trainer, Alan Samuels.
"Sometimes death is diagnosed quickly and in other cases it can take much longer, usually when the person is in hospital and there is more equipment to try and restart the heart," says nurse and resuscitation trainer, Alan Samuels.
"Normally the longer resuscitation goes on, the less chance there is of someone surviving, which is what makes the baby's case even more remarkable."
"Normally the longer resuscitation goes on, the less chance there is of someone surviving, which is what makes the baby's case even more remarkable."
Patients who have hypothermia or are drugged can seem dead. It can be difficult to feel a pulse if the heartbeat is very slow.
Patients who have hypothermia or are drugged can seem dead. It can be difficult to feel a pulse if the heartbeat is very slow.
Phobia
Phobia
Size is also a factor, as it is sometimes harder to hear a heart beat of a heavier person as there is more fat and muscle between the medical apparatus and the heart.
Size is also a factor, as it is sometimes harder to hear a heart beat of a heavier person as there is more fat and muscle between the medical apparatus and the heart.
"A lot of people have a phobia of being wrongly diagnosed as dead," says Mr Samuels.
"A lot of people have a phobia of being wrongly diagnosed as dead," says Mr Samuels.
"I think that stems from centuries ago when medicine was less sophisticated and most people did not die in hospital. In this day and age it is very rare to misdiagnose death.
"I think that stems from centuries ago when medicine was less sophisticated and most people did not die in hospital. In this day and age it is very rare to misdiagnose death.
"Death usually takes place in a hospital setting, where sophisticated equipment is used to revive the person and test for vital signs. In a hospital it is generally very obvious when someone has died."
"Death usually takes place in a hospital setting, where sophisticated equipment is used to revive the person and test for vital signs. In a hospital it is generally very obvious when someone has died."
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...which is the reason I want to be cremated. I remember watching a programme when I was younger which had a man waking up to find he was in his own coffin, 6 feet under. At least if they make a mistake and I'm alive, it won't take long to prove them right and me wrong.Sarah, Cannock, Staffs
