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Brain Death...Emergency

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In this page talks about ( Brain Death...Emergency ) It was sent to us on 05/08/2021 and was presented on 05/08/2021 and the last update on this page on 05/08/2021

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Prognosis of Brain Death











No one who meets the criteria for brain death recovers. Thus once brain death is confirmed the person can be considered dead.



After brain death is confirmed all life support is stopped. Family members may wish to be with the person at this time. They need to be told that one or more limbs may move when breathing assistance is ended or that the person may even sit up (sometimes called the Lazarus sign). These movements result from spinal reflex muscle contractions and do not mean the person is not really brain dead.


Diagnosis of Brain Death













A doctor's evaluation based on specific criteria




Occasionally other tests usually to make organ donation possible






There are specific criteria for diagnosing brain death. They include





Checking for and correcting all treatable problems that could alter brain function and thus result in a misdiagnosis of brain death (such as very low body temperature very low blood pressure or very low blood levels of certain substances such as sugar and sodium or an overdose of a sedative)




Identifying and treating any condition that could cause coma and irreversible loss of all brain function




Testing the person's reflexes (such as the gag reflex triggered by touching the back of the throat) and observing no response (the person does not grimace move or otherwise react)




Testing the eyes and observing no reaction to light




Testing breathing by taking the person off the ventilator and observing that the person makes no attempt to breathe






Doctors should maintain communication with the family or attempt to notify the person's next of kin or a close friend of their findings as soon as the diagnosis and evaluation of brain death begins.



Doctors typically recheck the criteria 6 to 24 hours later to confirm the person's lack of response.



All of the following must be done:





All treatable problems that could be misdiagnosed as brain death are ruled out.




A comprehensive neurologic examination has been done.




The required testing has been done.






In adults brain death can be confirmed after a second check is done 6 to 24 hours later. For children some states advise doctors to do two separate examinations separated by at least 48 hours.

Optional additional tests

Occasionally when results of the initial evaluation are uncertain or the evaluation cannot be completed doctors use certain diagnostic tests to help them diagnose brain death. Establishing the diagnosis of brain death quickly may be especially important when organ transplantation is planned—for example after catastrophic head injuries (as may occur in car crashes). The tests include





Electroencephalography (EEG—a recording of the brain’s electrical activity): This test shows no brain waves when a person is brain dead.




Imaging tests can be used to detect blood flow to the brain: No blood flows to the brain when a person is brain dead.






Imaging tests include positron emission tomography (PET) angiography CT angiography single photon emission computed tomography (SPECT—which uses a radioactive molecule called a radionuclide to produce images of blood flow) and Doppler ultrasonography of blood flow to the brain.



simple explanation



Brain death is the permanent loss of brain activity. As a result people cannot breathe or maintain other vital functions on their own and they permanently lose all awareness and capacity for thought.


Artificial means can maintain breathing and keep the heart beating for a while but once brain death occurs nothing can keep the other organs functioning indefinitely.


Doctors must use specific criteria to diagnose brain death.


No treatment can help a person who is brain dead.


A diagnosis of brain death is equivalent to a person's death.


Brain death means that the brain stops functioning. People do not respond to any stimuli. No treatment can help and once the diagnosis is confirmed a person is considered legally dead.


In the past the idea of brain death was irrelevant because when the brain died so did the rest of the body. That is the person stopped breathing and the heart stopped beating. However now artificial means (such as ventilators and drugs) can temporarily maintain breathing and the heart’s beating even when all brain activity stops. But eventually even with help from artificial means all the body's organs stop working. Nothing can keep the heart beating indefinitely once brain death occurs.


A doctor's evaluation based on specific criteria


Occasionally other tests usually to make organ donation possible


There are specific criteria for diagnosing brain death. They include


Checking for and correcting all treatable problems that could alter brain function and thus result in a misdiagnosis of brain death (such as very low body temperature very low blood pressure or very low blood levels of certain substances such as sugar and sodium or an overdose of a sedative)


Identifying and treating any condition that could cause coma and irreversible loss of all brain function


Testing the person's reflexes (such as the gag reflex triggered by touching the back of the throat) and observing no response (the person does not grimace move or otherwise react)


Testing the eyes and observing no reaction to light


Testing breathing by taking the person off the ventilator and observing that the person makes no attempt to breathe


Doctors should maintain communication with the family or attempt to notify the person's next of kin or a close friend of their findings as soon as the diagnosis and evaluation of brain death begins.


Doctors typically recheck the criteria 6 to 24 hours later to confirm the person's lack of response.


All of the following must be done:


All treatable problems that could be misdiagnosed as brain death are ruled out.


A comprehensive neurologic examination has been done.


The required testing has been done.


In adults brain death can be confirmed after a second check is done 6 to 24 hours later. For children some states advise doctors to do two separate examinations separated by at least 48 hours.


Occasionally when results of the initial evaluation are uncertain or the evaluation cannot be completed doctors use certain diagnostic tests to help them diagnose brain death. Establishing the diagnosis of brain death quickly may be especially important when organ transplantation is planned—for example after catastrophic head injuries (as may occur in car crashes). The tests include


Electroencephalography (EEG—a recording of the brain’s electrical activity): This test shows no brain waves when a person is brain dead.


Imaging tests can be used to detect blood flow to the brain: No blood flows to the brain when a person is brain dead.


Imaging tests include positron emission tomography (PET) angiography CT angiography single photon emission computed tomography (SPECT—which uses a radioactive molecule called a radionuclide to produce images of blood flow) and Doppler ultrasonography of blood flow to the brain.


No one who meets the criteria for brain death recovers. Thus once brain death is confirmed the person can be considered dead.


After brain death is confirmed all life support is stopped. Family members may wish to be with the person at this time. They need to be told that one or more limbs may move when breathing assistance is ended or that the person may even sit up (sometimes called the Lazarus sign). These movements result from spinal reflex muscle contractions and do not mean the person is not really brain dead.
  • The Author: wikbe
 
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