Diagnosis of death
- The definition or classification of death can also change based on the setting the patient is present in as well. For example in a mass casualty setting triaging a patient as "black" or dead, is done purely on the basis of responsiveness and spontaneous circulation and ventilation. 
- Note there is a distinction between pronouncing and certifying death. The former means assessing the patient and diagnosing death, whereas certifying death typically involves stating the cause of death as well.
- Brain death
- Drug overdose
- Persistent Vegetative State
- Electrolyte derangement
- Acidosis or Alkalosis
- Evaluation of the patient depends on the clinical setting the patient is in, as above, triage in settings of mass casualty changes the evaluation of death.
- The two main categories for diagnosis of death are cardiorespiratory and neurological.
- Cardiorespiratory: No spontaneous respiratory effort accompanied with 5 minutes of asystole- causing inadequate cerebral perfusion for long enough to cause neurologic compromise.
- Neurological: Two separate doctors must successfully declare the patient brain dead, preferably physicians skilled in neurological management, i.e. a neurologist or neurosurgeon.
- Patient in question needs to be uncoscious, apneic , and artificially ventilated.
- Clear etiology of severe brain injury.
- Consider all reversible causes of coma (differential above)
- Test brainstem reflexes, and demonstration they are absent
- Apnea testing 
Take care to acknowledge family needs.
- Tintinalli's Emergency Medicine