Although rare, doctors say that they have heard anecdotally of cases of apparently dead patients coming back to life. The updated advice is designed as a checklist, allowing them to be sure of their diagnosis in cases where it is hard to tell if a patient is still alive. The guidelines include a list of tests that doctors must carry out to confirm death. They should then discuss the results with relatives, it recommends. One test involves injecting ice into a patient's ear to test for a reaction in their eyelids. Another to check that a patient's pupils remain fixed and do not move in response to sharp changes in the intensity of light. A third that a spatula should be put towards the back of the throat to test if the patient gags. The guidelines replace previous advice issued a decade ago and also take into account advances in modern medicine, such as the increasing sophistication of life support, where machines can take over the breathing of patients. Sir Peter Simpson, an anaesthetist who led the team which drew up the new guidelines, said that the process of deciding if a patient was dead or not could be difficult. He pointed to unusual circumstances such as people who die while taking sedatives. "This new guidance for the first time clearly spells out when it is appropriate to diagnose death. "Diagnosing death in whatever circumstances is a sensitive issue, which comes at a very distressing time for everyone. "We hope that the detailed way in which the working party has addressed the issues will give help and confidence to all concerned." The guidelines have been drawn up by experts at the Academy of Medical Royal Colleges. Source
Apnic test Gag reflex can be done by moving the intubation tube back and forth a little Doll test moving the head to one side the eyes should move to the other side
