Hosps can't declare hypothermic patients 'dead'

After a premature baby, who was alive, was declared dead by a private hospital, the Indian Medical Association (IMA) has issued an advisory stating that a person should never be declared dead under conditions of hypothermia.

"It is important to recognise hypothermia so that patients can be revived timely using all resuscitative measures, including rewarming, CPR," the IMA said in a statement issued on Saturday. The boy was one of the twins who had been declared dead by a leading hospital.

Hypothermia is a condition where the core body temperature is below 95 degrees Farenheit.

The matter came to light after the father of the children, Ashish Kumar, who was on his way to the cremation ground, noticed that one of the polybags handed over by the doctors was moving.

The family alleged that the twin babies were declared dead after they expressed their inability to pay the exorbitant fee for their treatment. The advisory said that in conditions of severe hypothermia in children, body metabolism is suspended, which may protect against hypoxia. Patients with core body temperature 82 degrees F have been known to survive anoxia for 12-18 minutes and up to 60 minutes or more at core body temperature of 68 degrees F.

"Sometimes hypothermic patients can be successfully revived even with total resuscitation time of nine hours. Because of dilated pupils, asystole, hyper-ventilation, and absence of shivering, the patient appears dead. Because of the failure to recognise this state, patients are at times declared dead," it added.

Successful revival is also possible in adults because of the neuroprotective effects of hypothermia. Efforts to revive the patient should be continued till the core body temperature reaches 90-95°F i.e. bring down the temperature from severe hypothermia to mild hypothermia or normal. If the patient still cannot be revived with CPR, then he/she can be declared dead.