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  #1  
Old 12-05-2011
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Neuro Diagnosis of Brain Death

An 80 ,year-old man is admitted to the hospital with a massive intracranial bleed. He has been placed on a ventilator because of tbe respiratory failure associated with intracranial herniation, When you try to remove the ventilator there are no respirations.
The patient makes no purposeful movements. There is no pupillary reaction when you shine a light in his eyes. There is no nystagmus on cold caloric question testing. Oculocephalic and corneal reflexes are absent. He left no specific wishes for his care.
Which of the following is the most appropriate action regarding this patent?

1- Remove the ventilator.
2- Make the patient DNR.
3- Place a nasogastric tube to prevent aspiration.
4- Get a court order authorizing you to remove the ventilator.
5- Do an EEG (electroencephalogram) three times separated by 6 hours each time.
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  #2  
Old 12-05-2011
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A

brain death has occurred so no fun for ventilator
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Old 12-05-2011
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A...
pt is brain dead!! there is nothing u can do!!
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Old 12-05-2011
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Originally Posted by shyangel18 View Post
A...
pt is brain dead!! there is nothing u can do!!
Still you can keep him alive.Should it not be the court to decide
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Old 12-05-2011
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i think A
but E seems good
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i think its E
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ill go with the 4th option..........can we know the correct answer guys??????
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Old 12-05-2011
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Correct Answer answer is A

it should be A no doubt, the doctor decides when the pt is brain dead not the court. ya if the que was about pt's mental ability to judge or give consent then court because that is a legal problem
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Old 12-06-2011
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Originally Posted by drmirzanaveed View Post
it should be A no doubt, the doctor decides when the pt is brain dead not the court. ya if the que was about pt's mental ability to judge or give consent then court because that is a legal problem
But if you do remove the ventilator and find your self in a lawsuit what you gonna do.Is it not better to leave it to the court
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(a) Remove the ventilator.
The patient meets the criteria for brain cleath.T hese are: negative corneal reflex, no nvstagmus rn response to caloric stimulation of the tympanic membranes, negative pupilary and oculocephalic reflexes, and the absence of ,ponon.o.,, respiration when the ventilator is held. Ifthere are no brainsten reflexesa n.1t he patient will not spontaneously breathe, then the patient is brain dead. There is no hope ol recovery in this circumstance.
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Old 12-07-2011
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Quote:
Originally Posted by miss patho View Post
(a) Remove the ventilator.
The patient meets the criteria for brain cleath.T hese are: negative corneal reflex, no nvstagmus rn response to caloric stimulation of the tympanic membranes, negative pupilary and oculocephalic reflexes, and the absence of ,ponon.o.,, respiration when the ventilator is held. Ifthere are no brainsten reflexesa n.1t he patient will not spontaneously breathe, then the patient is brain dead. There is no hope ol recovery in this circumstance.
yup!!! you r right , there is nothing to do, remove the ventilator....
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MedicoLegal-Ethics, Nervous-System-, Physiology-, Step-1-Questions

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