death criterias

Question 1

what confounders need to be abscent for neurological criteria

Answer 1

Temperature: core ≥ 36 celsius (rectal, esophageal, bladder, arterial, bladder, central venous)
Time: wait ≥ 48hrs after arrest (unless imaging shows devastating injury)
Drugs: Wait 5 half lives if drug is known (e.g. sedatives, neuromuscular blockers)
Shock: Must be resuscitated appropriately (i.e. not un-resuscitated)
Metabolic disorders*: Na 125-159, PO4 >0.4, Glucose 3-30, pH 7.28-7.5, PaCO2 < 60, Urea < 40 (if available), Cr < 400, bilirubin < 100
Severe weakness: myasthenia, ALS, spinal cord injury Decompressive craniectomy

Question 2

if confounders cannot be corrected in the DNC diagnosis, what needs to be done

Answer 2

ancillary investigation should be considered

Question 3

3 criteria to confirm dnc

Answer 3

1. Absence of consciousness – no wakefulness or response to stimuli
2. Absence of brainstem function – no brainstem reflexes
3. Absence of capacity to breathe

Question 4

apnea testing threshold for com[pletion

Answer 4

Thresholds for completion: PaCO2 > 60 mmHg AND > 20 mmHg above the pre-apnea baseline AND pH ≤ 7.28.

Question 5

ionotrope to use in organ donation . to avoid . what can you add ?

Answer 5

1st- vaso
2nd - noepi

dopamine to avoid

can add vasopressor

Question 6

core temperature for organ donation if kidneys being consdierd ?

Answer 6

34-35

Question 7

for neurological injuries, how long shoudl wait before consideration of withdrawal of life ?

Answer 7

72H