![]() Includes potassium, sodium, magnesium, phosphate, and calcium levels.Includes any known thyroid or adrenal abnormalities.Endocrine abnormalities (usually can be excluded from the history).Includes any unknown drug substances used.It is also essential to exclude or correct any reversible causes present that may account for the patient’s condition, prior to continuing with the testing. There should also be certainty that the patient has sustained an irreversible brain damage of known cause. Preconditions and Exclusion CriteriaĪny patient considered for potential brainstem testing should be (1) deeply unconscious (2) apnoeic (3) mechanically ventilated. The tests should be performed by both doctors together and successful completion is required on two separate occasions. There are certain preconditions that must be fulfilled and potentially reversible causes excluded prior to formal brainstem testing.īrainstem testing in the UK should be performed by two qualified doctors, both of whom are competent with the procedure, have full registration with the GMC for > 5 years, and one is a consultant. ![]() It focuses predominantly on UK practice, criteria for assessment and the procedure of testing may vary between countries This article aims to outline the aspects of brainstem death and the process involved in confirming the diagnosis. Timely identification of brainstem dead patients is important, as whilst there is no possibility of recovery, it may allow for appropriate referral for organ donation. Even with ventilatory support, brainstem dead patients will continue to deteriorate and eventually develop multi-organ failure due to loss of biological function The diagnosis of brainstem death is relevant to a number of clinical situations and unfortunately is a commonly performed test in many critical care units.īrainstem death can be defined as the absence of brainstem reflexes, motor responses, and respiratory drive in a deeply unconscious patient with an irreversible widespread brain lesion of a known cause and no contributing metabolic derangements.īrainstem death is different to persistent vegetative state (where the patient is also in an irreversible unconscious state) as brainstem dead patients will not survive without respiratory support. ![]()
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