Brain death Flashcards
what is the criteria for brain stem death testing?
Deep coma of known aetiology
Reversible causes excluded
No sedation
Normal electrolytes
what does the brain stem testing involve?
Fixed pupils which do not respond to sharp changes in the intensity of incident light
No corneal reflex
Absent oculo-vestibular reflexes - no eye movements following the slow injection of at least 50ml of ice-cold water into each ear in turn (the caloric test)
No response to supraorbital pressure
No cough reflex to bronchial stimulation or gagging response to pharyngeal stimulation
No observed respiratory effort in response to disconnection of the ventilator for long enough (typically 5 minutes)
who should the test be undertaken by?
two appropriately experienced doctors on two separate occasions.
Both should be experienced in performing brain stem death testing and have at least 5 years post-graduate experience.
One of them must be a consultant.
Neither can be a member of the transplant team (if organ donation contemplated).
