Tuesday, August 29, 2017

Brain death

PulmCrit (EMCrit)

PulmCrit - August 28, 2017 - By Josh Farkas
"There is no room for error when diagnosing brain death. Incorrect diagnosis causes inappropriate withdrawal of care. However, delayed or missed diagnoses lead to futile care and lost opportunities for organ donation...
Summary The Bullet:
  • Brain death diagnosis should be considered only after patient stabilization and evaluation for other possible causes of coma.
  • Spinal reflexes may produce strange movements among brain dead patients, often causing confusion.
  • The most concerning mimics of brain death are missed alternative diagnoses (e.g. intoxication, C-spine injury), because these may be treatable.
  • Radionuclide flow scan may be used in confusing situations. The scan isn't entirely sensitive, because limited flow may continue in the early phases of brain death. However, lack of blood flow allows for a confident diagnosis of brain death (high specificity)."