Brain death

Question 1

What does GCS stand for? What are the main tests?

Answer 1

• Glasgow Coma Scale
• Eyes open
• Best motor response
• Best verbal response

Question 2

What is locked in syndrome?

Answer 2

• Cannot move/speak
• Damage to ventral pons
• Feel pain, touch, limb position, able to breathe
• Usually caused by brain stem stroke

Question 3

What is a persistent vegetative state?

Answer 3

• Unconscious/unaware
• Unresponsive to exterma stimuli- possibly pain
• Eyes open, can track, dysconjugate
• Chronic wakefulness
• May smile, cry, moan, shout
• If not recovered from vegetative state after 30days

Question 4

What is brain stem death?

Answer 4

• Unable to breathe & unconscious
• Destroyed reticular formation
• No electrical activity

Question 5

What are preconditions of brain stem death?

Answer 5

• Diagnosis compatible with brain stem death
• Apnoeic
• Presence of irreversible structural brain damage

Question 6

What are exclusions of brain stem death?

Answer 6

• Drug effects
• Hypothermia
• Metabolic/endocrine abnormalities
• Intoxification

Question 7

What clinical tests can be done to confirm brain stem death?

Answer 7

• Absent brain stem reflexes: pupils, corneal, no gag/cough/vestibulo- ocular
• Persistent apnoea
• 2Practitioners on 2 occasions

Question 8

What is minimally conscious state?

Answer 8

• Severely altered unconsciousness
• Limited self/environmental awareness
• Follow simple commands