You are a medicolegal death investigator, and tonight you have a third-year medical student riding with you on the last night of his elective clinical rotation in Forensic Pathology (and his first, and only, night in the field). At 1834 hours you are dispatched to the Regional Medical Center concerning the death of a physician. Investigation reveals that the doctor was sitting at a Nurse’s station, writing orders. He was conversing with people, and was reportedly in a good mood without expressed complaint. All of a sudden, he was seen to get a horribly-pained look on his face; he began to arise from his seated position as he grabbed his head, saying “Oh, oh, my head, I’ve never had pain like this” then “I don’t want to be Coded” (resuscitated). He thereupon collapsed to the floor, was seen to take approximately 7-8 agonal breaths, and then became apneic, although he still had a pulse. A respiratory therapist present opened the physician’s airway, told others to call a Code Blue, and requested a bag-valve-mask resuscitator or resuscitation mask. A nurse on the scene intervened, saying “But, the doctor said he didn’t want to be coded.” There was hurried discussion among the physicians, nurses, and other health professionals as to what should be done. The assessment was quickly made that the doctor had, in fact, made an informed refusal of resuscitation. According to those on the scene, it was three long minutes after apnea that Carotid pulsations were noted to cease. The medical student asks you what you believe is the most likely cause and mechanism of the physician’s death. Your quick reply is “That’s why we’ll do an autopsy tomorrow.” The medical student protests, saying he will be on a plane in the morning, on his way to his next rotation. He again plaintively asks you for your opinion. You caution him about “leaping to conclusions in the absence of complete evidence,” but then decide to give him a thorough answer, which is…?

Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
Chapter1: The Human Body: An Orientation
Section: Chapter Questions
Problem 1RQ: The correct sequence of levels forming the structural hierarchy is A. (a) organ, organ system,...
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You are a medicolegal death investigator, and tonight you have a third-year medical student riding with you on the last night of his elective clinical rotation in Forensic Pathology (and his first, and only, night in the field). At 1834 hours you are dispatched to the Regional Medical Center concerning the death of a physician. Investigation reveals that the doctor was sitting at a Nurse’s station, writing orders. He was conversing with people, and was reportedly in a good mood without expressed complaint. All of a sudden, he was seen to get a horribly-pained look on his face; he began to arise from his seated position as he grabbed his head, saying “Oh, oh, my head, I’ve never had pain like this” then “I don’t want to be Coded” (resuscitated). He thereupon collapsed to the floor, was seen to take approximately 7-8 agonal breaths, and then became apneic, although he still had a pulse. A respiratory therapist present opened the physician’s airway, told others to call a Code Blue, and requested a bag-valve-mask resuscitator or resuscitation mask. A nurse on the scene intervened, saying “But, the doctor said he didn’t want to be coded.” There was hurried discussion among the physicians, nurses, and other health professionals as to what should be done. The assessment was quickly made that the doctor had, in fact, made an informed refusal of resuscitation. According to those on the scene, it was three long minutes after apnea that Carotid pulsations were noted to cease. The medical student asks you what you believe is the most likely cause and mechanism of the physician’s death. Your quick reply is “That’s why we’ll do an autopsy tomorrow.” The medical student protests, saying he will be on a plane in the morning, on his way to his next rotation. He again plaintively asks you for your opinion. You caution him about “leaping to conclusions in the absence of complete evidence,” but then decide to give him a thorough answer, which is…?
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