Brain death

Criteria

1) Known proximate cause of contidition

2) Exclusion of complicating medical conditions (severe electrolyte, acidbase, or endocrine disturbance)

3) No drug intoxication/poisoning

4) Core temp >32C (90F)

5) Cerebral unresponsiveness

6) Absence of brain stem relexes (see below)

7) Apneic (see below)

8) Irreversible condition (+/- repeat exam in 6hrs)

1. Pupils

-no response to light (fixed and mid-dialated)

2. Ocular movement

-no oculocephalic reflex (deviation of eyes to irrigation w/ 50mL cold water to ears - allow 1 min after and 5 min b/t)

3. Facial motor response/sensation

-jaw reflex (grimacing to deep facial pressure)

-corneal reflex (touch eye w/ swab)

4. Paryngeal/tracheal

-gag (tounge blade)

1. Prerequisites:

-Core temp >36.5 C (97 F)

-SBP >90

-Corrected DI

-Nl PCO2 (>40)

-Nl PO2 (preoxiginate >200)

2. Test:

Connect pulse ox, disconnect ventilator, place nasal cannula in ET (at carina), observe for resp movements, draw ABG @ 8 min

Pos test = PCO2 >60 (or 20 increase over baseline)

reconnect ventilator if SBP <90 or sig O2 desat (can draw ABG @ that time, with same criteria as above)

One-Legacy 800-338-6112

2/8/07 DONALDSON (adapted from One-Legacy)

Authors: