What is the difference between

• Found Dead
• Brought Dead, Brought in Dead, Dead on Arrival
• Expired

All these related to situations when the patient is dead. When an alive patient leaves an hospital, we have situations like Discharge, Discharge at request, Discharged Against Medical Advice, Left Against Medical Advice, Absconded which are discussed in detail in this page. The question whether Unconscious Patients / Patients on Ventilatory Support be discharged Against Medical Advice AMA, DAMA, LAMA is dealt separately

Now let us define the various situations in simpler terms

Found Dead

• Means that the person who found the body itself noticed that there was no life in it.
• There was no sign of life when the body was found elsewhere (road side or in an house unattended)
• The body is being brought to the hospital (usually by the police or other government agency or Ambulance or Bystanders) for postmortem examination or for storage in the hospital.
• The doctor need not start treatment.
• It is enough if an entry is made in AR , Police are informed about the MLC and the body sent to mortuary.

Brought Dead, Brought in Dead, Dead on Arrival

• They all mean the same
• There refer to a patient who has been brought to the casualty
• The patient is being brought for treatment.
• (Presumably) at the time, when they started the journey to the hospital, the patient was alive (or at least that is what those who accompanied the patient thought so) . . .
• On reaching the hospital, examination reveals that the patient is dead.
• In such case, when history reveals that the patient was alive few minutes ago, the doctor has to admit the patient and start CPR.
• CPR Should be done for minimum of 45 minutes.
• If Defib is available, DC Shock may be given.
• In few countries, even direct cardiac massage is given.
• If the patient is a child, CPR Should be done for at least one hour before the child is declared dead
• Entry is made in AR , Police are informed about the MLC, Body is sent to Mortuary

Expired, Dead

• This refers to the patient who was being treated in a ward and suffers a cardio respiratory arrest (or a cardiac arrest and subsequent respiratory arrest or a respiratory arrest and subsequent cardiac arrest)
• CPR was done
• Patient could not be reviewed

Brain Dead

• This refers to a patient who has been certified as Brain Dead as per the Rules

To Sum Up

Found dead

• Make Entry in AR, Make it MLC, Inform Police, Send to Mortuary

Brought dead, Dead on Arrival –> CPR

• If CPR is successful send to ICU
• If CPR is not successful, Make Entry in AR, Make it MLC, Inform Police,  send to Mortuary

Cardiac Arrest / Respiratory Arrest –> CPR

• If CPR is Successful, shift to ICU and continue treatment
• If CPR is not successful, declare as “Dead / Expired” Make Entry in AR, Make it MLC, Inform Police, send to Mortuary

Brain Dead

• If Willing for Organ Donation, and if organs are to be donated, shift to operation theatre and then from OT to Mortuary and
• If organs are not to be donated, treat till cardiac arrest that cannot be revived and mention the time of cardiac arrest and send to Mortuary
• “Time of Death” is Time of Certification of Brain Death ie Time of Second Apnea Test and not the time of cardiac arrest.

Related

• When an alive patient leaves an hospital, we have situations like Discharge, Discharge at request, Discharged Against Medical Advice, Left Against Medical Advice, Absconded which are discussed in detail in this page.

• The question whether Unconscious Patients / Patients on Ventilatory Support be discharged Against Medical Advice AMA, DAMA, LAMA is dealt separately