scholarly journals Differences in the definition of brain death and their legal impact on intensive care practice

Anaesthesia ◽  
2019 ◽  
Vol 74 (5) ◽  
pp. 569-572 ◽  
Author(s):  
A. McGee ◽  
D. Gardiner
Keyword(s):  
Intensive Care ◽  
Brain Death ◽  
Care Practice ◽  
Definition Of

Adults Who Lack Capacity to Consent and Deprivation of Liberty

2020 ◽  
pp. 93-110
Author(s):  
Daniele Bryden
Keyword(s):  
Intensive Care ◽  
Best Interests ◽  
Care Practice ◽  
Intensive Care Treatment ◽  
The Us ◽  
Life Threatening ◽  
Substituted Judgement ◽  
Sound Mind ◽  
Definition Of ◽  
Mental Capacity Act

The basic presumption of the Mental Capacity Act that an individual has capacity to make decisions regarding treatment is frequently challenged within intensive care practice where individuals are often incapacitated due to the nature of their condition or treatment for it. Because many conditions are life-threatening, treatment is frequently administered on the basis of an assumption that it provides an overall benefit to the person and that their interests are best served by preservation of life. There is now a statutory definition of best interests although factors in its determination can at times be opaque, which suggests a gradual move towards the US-based ‘substituted judgement’ test. An individual can be lawfully prevented from leaving the intensive care unit while receiving intensive care treatment provided that treatment is given in good faith and is materially the same as would be given to a person of sound mind with the same physical illness.

scholarly journals Performing the Brain Death Examination and the Declaration of Pediatric Brain Death

2017 ◽  
Vol 06 (04) ◽  
pp. 229-233 ◽  
Author(s):  
Melissa Porter ◽  
Susan Martin
Keyword(s):  
Intensive Care ◽  
Brain Death ◽  
Pediatric Intensive Care ◽  
Care Providers ◽  
Apnea Test ◽  
Brain Death Determination ◽  
Definition Of ◽  
Death Determination ◽  
Pediatric Brain ◽  
The Brain

AbstractDeclaration of brain death is a clinical diagnosis made by the absence of neurological function in a comatose patient secondary to a known irreversible cause. Brain death determination is not an infrequent process in pediatric intensive care units. It is important that pediatric intensive care providers understand the definition of brain death and intensivists are able to implement brain death testing. The following is a narration detailing the process of brain death determination by physical examination. First, the prerequisites that determine patients' eligibility for brain death testing will be outlined. Next, each part of the physical exam, including the apnea test, will be described in detail. Finally, how the declaration of brain death is made is stated. In addition, special considerations and ancillary testing will be briefly highlighted.

Judgmental Error in Intensive Care Practice

1990 ◽  
Vol 5 (3) ◽  
pp. 93-103 ◽  
Author(s):  
Gilbert M. Goldman
Keyword(s):  
Intensive Care ◽  
Care Practice

scholarly journals New Definition of Sepsis

2013 ◽  
Vol 2 (1) ◽  
pp. 37
Author(s):  
Fuzhou Wang
Keyword(s):  
Septic Shock ◽  
Intensive Care ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Organ Dysfunction ◽  
Medical Science ◽  
Accurate Diagnosis ◽  
Causes Of Mortality ◽  
New Challenges ◽  
Definition Of

Sepsis or septic shock is one of the major causes of mortality in intensive care medicine. How to define and how to make an accurate diagnosis possess critical implications for patients and intensive caregivers. With the development of modern medical science, new challenges rose for how to re-define sepsis and also revision is needed. Should we add organ dysfunction to the diagnostic criteria of systemic inflammatory response syndrome, and whether are there early symptoms or signs of organ dysfunction need to be considered critically. May be the new definition of sepsis can save more lives.

scholarly journals Practice Current: When do you order ancillary tests to determine brain death?

2018 ◽  
Vol 8 (3) ◽  
pp. 266-274 ◽  
Author(s):  
Nathaniel M. Robbins ◽  
James L. Bernat
Keyword(s):  
Brain Death ◽  
Clinical Examination ◽  
Online Survey ◽  
Mechanism Of Injury ◽  
Preliminary Results ◽  
Definition Of Death ◽  
Primary Mechanism ◽  
Brainstem Injury ◽  
Definition Of ◽  
Case Based

Brain death has been accepted as a legal definition of death in most countries, but practices for determining brain death vary widely. One source of variation is in the use of ancillary tests to assist in the diagnosis of brain death. Through case-based discussions with 3 experts from 3 continents, this article discusses selected aspects of brain death, with a focus on the use of ancillary tests. In particular, we explore the following questions: Are ancillary tests necessary, or is the clinical examination sufficient? What ancillary tests are preferred, and under which circumstances? Are ancillary tests required when the primary mechanism of injury is brainstem injury? Should the family's wishes play a role in the need for ancillary tests? The same case-based questions were posed to the rest of our readership in an online survey, the preliminary results of which are also presented.

Brain Death

2017 ◽  
Author(s):  
Anupamaa Seshadri ◽  
Ali Salim
Keyword(s):  
Brain Death ◽  
Apnea Test ◽  
Brainstem Reflex ◽  
Practice Parameters ◽  
Confirmatory Tests ◽  
History Of ◽  
Pediatric Populations ◽  
Definition Of

The concept of “brain death” is one that has been controversial over time, requiring the development of clear guidelines to diagnose and give prognoses for patients after devastating neurologic injury. This review discusses the history of the definition of brain death, as well as the most recent guidelines and practice parameters on the determination of brain death in both the adult and pediatric populations. We provide specific and detailed instructions on the various clinical tests required, including the brain death neurologic examination and the apnea test, and discuss pitfalls in the diagnosis of brain death. This review also considers the most recent literature and guidelines as to the role of confirmatory tests making this diagnosis.  Key Words: apnea test, brain death, brainstem reflex, death examination

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