International Commission for Mountain Emergency Medicine (ICAR MedCom), Zürich, Switzerland; Institute of Forensic Medicine, University of Bern, Bern, Switzerland.
International Commission for Mountain Emergency Medicine (ICAR MedCom), Zürich, Switzerland; University Hospitals, Morecambe Bay Trust, Royal Lancaster Infirmary, Lancaster, United Kingdom.
Wilderness Environ Med. 2020 Dec;31(4):506-520. doi: 10.1016/j.wem.2020.06.013. Epub 2020 Oct 17.
Determination of death requires specific knowledge, training, and experience in most cases. It can be particularly difficult when external conditions, such as objective hazards in mountains, prevent close physical examination of an apparently lifeless person, or when examination cannot be accomplished by an authorized person. Guidelines exist, but proper use can be difficult. In addition to the absence of vital signs, definitive signs of death must be present. Recognition of definitive signs of death can be problematic due to the variability in time course and the possibility of mimics. Only clear criteria such as decapitation or detruncation should be used to determine death from a distance or by laypersons who are not medically trained. To present criteria that allow for accurate determination of death in mountain rescue situations, the International Commission for Mountain Emergency Medicine convened a panel of mountain rescue doctors and a forensic pathologist. These recommendations are based on a nonsystematic review of the literature including articles on determination of death and related topics.
在大多数情况下，确定死亡需要特定的知识、培训和经验。当外部条件（如山区的客观危险）阻止对明显无生命的人进行近距离体检，或者无法由授权人员进行体检时，情况可能会特别困难。虽然有相关的指导方针，但正确使用这些指导方针可能会有难度。除了没有生命迹象外，还必须存在明确的死亡迹象。由于时间进程的可变性和可能出现的类似情况，明确的死亡迹象的识别可能会存在问题。只有明确的标准，如断头或截断，才应被用于远距离或未经医学培训的非专业人员来确定死亡。为了提出在山地救援情况下能够准确确定死亡的标准，国际山地紧急医学委员会召集了一组山地救援医生和法医病理学家。这些建议是基于对文献的非系统性回顾，包括关于确定死亡和相关主题的文章。
