The physician must understand this difference, as brain death means that life support is futile, and brain death is the principal prerequisite for the donation of organs for transplantation. There is a clear difference between severe brain damage and brain death. When this primary treatment is unsuccessful and the patient's condition evolves to brain death, the critical care physician has the responsibility to diagnose brain death with certainty and to offer the patient's family the opportunity to donate organs and / or tissues. Initial therapy provided for patients with severe brain injury or insult, is directed towards preservation and restoration of neuronal function. In the practice of critical care, ‘the care of a severely brain injured patient ’ is one of the toughest challenges for a critical care physician. Certification and brain death documentation.
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Repeat clinical assessment of brain stem reflexes. Clinical observations compatible with the diagnosis of brain death. Performance of a complete neurological examination including the standard apnea test and 10 minute apnea test.
Exclusion of any condition that might confound the subsequent examination of cortical or brain stem function. Identification of history or physical examination findings that provide a clear etiology of brain dysfunction. Process for brain death certification has been discussed under the following: 1. The purpose of this review article is to provide health care providers in India with requirements for determining brain death, increase knowledge amongst health care practitioners about the clinical evaluation of brain death, and reduce the potential for variations in brain death determination policies and practices amongst facilities and practitioners. Physicians need not be, or consult with, a neurologist or neurosurgeon in order to determine brain death.
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There is a need to diagnose brain death with utmost accuracy and urgency because of an increased awareness amongst the masses for an early diagnosis of brain death and the requirements of organ retrieval for transplantation. Vital functions can now be maintained artificially for a long period of time after the brain has ceased to function. Although the widespread use of mechanical ventilators and other advanced critical care services have transformed the course of terminal neurologic disorders. Physicians, health care workers, members of the clergy, and laypeople throughout the world have accepted fully that a person is dead when his or her brain is dead.