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How do you determine if someone is brain-dead? Study shows hospitals disagree

Accreditation Insider, January 5, 2016

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Determining if a patient’s brain functions have irreversibly shut down is a crucial diagnosis; in many places it’s the same as declaring them fully dead. There are several recoverable conditions such as hypothermia and adverse drug reactions that can imitate brain-death, and of course, mistakenly declaring someone brain-dead when they are actually suffering from recoverable condition can potentially lead to disastrous mistakes. Delays in diagnosing brain-death can make a patient’s organs less viable for transplant, making a quick and efficient procedure vital.
To ensure that facilities made the correct steps when declaring brain-death, the American Academy of Neurology (AAN) published guidelines for diagnosing brain-death in 2010. Hospitals have been recommended to have their brain-death policies be that 100% compliant with the AAN guidelines.
Despite this, a new study in The Journal of the American Medical Association found that policies around brain-death vary wildly from hospital to hospital.
Researchers found that 43.8% of hospitals didn’t screen for hypotension when testing for brain-death, and 20.6% didn’t screen for hypothermia. The report also noted a confusion over who can declare a patient brain-dead. Of the 492 hospitals studied, 23.8% didn’t have any policies on who could declare a patient brain-dead and 43.1% of hospitals just said an attending physician needed to make the call. The remaining 33.1% just required that a healthcare professional have specific expertise in neurology or neurosurgery to make the determination.
Check out the study here.



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