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Brainstem death - Coggle Diagram
Brainstem death
Test
Pupillary Reflex II,III
Corneal V, VII
Painful stimulus V, VII
Vestibulo-ocular VIII - III, IV, VI
Gag reflex
IX, X
Cough reflex X
Academy of Medical Royal Colleges
Essential preconditions
unconcious
apnoic
mechnically ventilated
Irreversible brain damage of known aetiology
Exclusion of potentially reversible cause
Circulatory
MAP>60
Respiratory
Normal pH
C02 <6
Pa02>10
Tempreture >34
Biochemical
Na 115-160
K>2
Mg 0.5-3
Phos >0.5
Glucose 3-20
Drugs
2-3x half life
Test for midazolam or thiopentone levels
Red flags
< 6 hours sedation
< 6 hours
< 6 hours therpeutic
Fentanyl infusion
Use of steriods
Difficulties
Residual sedative effects
cervical cord injury
Maxilofacial injury
Ancillary tests
Electrical
EEG
SSEP
Flow
Angiogrpahy
Trancranial doppler