BDT Foundations
This one word in the definition of brain death explains why doctors must wait and observe instead of declaring immediately.
What is permanent (irreversible)?
The recommended minimal wait time after rewarming from TTM before brain death testing.
What is 24 hours?
The number of exams required for brain death declaration in adults.
What is one?
The required pH on pre-apnea exam ABG.
What is 7.35-7.45?
Minimal corrected gestational age for brain death to be legitiamte.
What is 37 weeks?
Brain death is defined as the complete and permanent loss of this.
What is all brain and brainstem function?
The BAL level of which brain death testing may proceed.
What is ≥80mg/dL?
This is required if any component of the physical exam or the apnea test cannot be performed.
What is ancillary testing?
The recommended PaO2 level at the start of the apnea test.
What is ≥ 200?
The recommended observation period for pediatric patients patients ≤ 48 months of age.
What is 48 hours?
The acceptable professional credentials allowoing a person to legally declare BD in Colorado.
What are MD or DO?
The three vital signs needed for brain death declaration in an adult patient.
What are...
7 ≥36*
Systolic BP >100
MAP ≥ 85
The presence of these reflexes does not prelude the declaration of brain death.
What are the spinal reflexes?
The 2 major stimuli to respiratory drive.
What are acidosis and pCO2 level?
The minimal time between 2 pediatric clinical exams.
What is 12 hours?
The document with the ultimate authority regarding brain death testing at any given hospital.
What is hospital policy?
The C-spine imaging finding which precludes the use of apnea test for brain death testing.
What is cervical cord injury above the level of CN?
The brain stem reflex also known as Dolls Eyes.
What is the oculocephalic reflex?
When observed during an apnea test, this negates brain death declaration.
What is respiratory effort?
2 : 2 : 2
What are the number of clinicians, exam, and apnea tests needed for brain death declaration in pediatric patients?
This step formally confirms death and must be completed before any organ recovery process can begin.
What is declaration?
or
documentation of the brain death determination?
Neuroimaging must confirm this.
What is a devastating neurologic injury?
The three stimuli tested to determine responsiveness.
What are...
Visual (light)
Touch (pain)
Sound
The 3 ABG results needed for an apnea test to be positive for brain death.
What are
pH < 7.3
pCO2 rise of greater than 20
pCO2 greater than 60
The 2 primitive reflexes which must be absent in infants younger than 6 months.
What are the sucking and rooting reflexes?