Brain stem death (patient information)

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Common causes of brain stem death

• Severe brain swelling after a serious fall or traffic accident or trauma
• Massive brain haemorrhage
• Severe or long time of anoxia

How to know you have brain stem death?

A series of strict tests need to be carried out by two senior doctors who are not members of transplant team. The tests are done at the patient's bedside. These tests are frequently repeated to confirm that tha patient's brain stem has stopped working. All the following criteria need to be met before brain stem death can be pronounced.

• Clinical tests for absent brain stem reflexes

• No pupillary response to light
• No blanking on corneal touch
• No eye movement on caloric testing
• No grimacing on paiful stimuli
• No cough or gag reflex
• No vestibulo-ocular reponse

• Test for confirmation of persistent apnoea. The procedure is the following:

• Preoxygenation with 100% oxygen for 10 minutes
• Allow PaCO2 to rise above 5.0 kPa before test
• Disconnect from ventilator
• Maintain adequate oxygenation during test
• Allow PaCO2 to climb above 6.65 kPa
• Confirm no spontaneous respiration
• Reconnect ventilator

Where to find medical care for brain stem death?

Directions to Hospitals Treating brain stem death

Copyleft Sources

http://www.surgical-tutor.org.uk/default-home.htm?core/trauma/head_brain.htm~right

http://www.uktransplant.org.uk/ukt/how_to_become_a_donor/questions/answers/further_info/brain_stem/the_brain_stem_more.jsp

http://www.bartsandthelondon.nhs.uk/docs/brain_stem_death_2009_gmandersloot.pdf

http://www.ich.ucl.ac.uk/gosh_families/information_sheets/death_brain_stem/death_brain_stem_families.html

http://www.nhs.uk/conditions/Brain-death/Pages/Introduction.aspx