The brain controls not only an individual’s thought process and voluntary movements, but it controls involuntary movements and other vital body functions. The brain has a number of vast jobs to complete every second and is a very complex organ. And patients who are in coma may or may not progress to brain death. First things first, patients who suffer brain death are not in coma. These tests are repeated and witnessed by each senior doctor to confirm that the brain stem has stopped working.In light of Whitney Houston and Bobby Brown’s daughter, Bobbi Kristina being found unconscious, there have been many headlines that said she in “a coma” or a “vegetative state” or even “brain dead”. The doctors will also look for any signs of breathing during the time off the ventilator, which can be between five and 10 minutes. Blood tests will be taken from one of the lines in the child’s artery to measure carbon dioxide in the blood before and after the disconnection. The child does not breathe when taken off the ventilator.ĭuring this time, it is necessary for the level of carbon dioxide in the child’s blood to rise and exceed the level that always stimulates a breath. The child’s eyes do not blink when the surface of eyeball is stroked with a piece of tissue or cotton wool.
The child does not respond to pain when pressure is applied to certain areas of the body. The child does not show any cough or gag reflex – coughing or choking when the back of the throat is stimulated or the breathing tube is suctioned. The child’s natural eye movements are absent. The child’s pupils – the small black parts in the centre of each eye – do not respond to a direct light being shone in their eyes. They follow a nationally agreed protocol and are conclusive.īefore the tests are started, checks are made to make sure that any factors which might affect the tests such as medicines or an extremely low body temperature have been ruled out.Īll the following criteria need to be met before brain stem death can be certified: This ensures independent checking of the results of these tests. One of these doctors will be from another team in the hospital so not involved in the child’s care. The tests used to determine brain stem death are carried out by two senior doctors at the child’s bedside. What tests are used to confirm brain stem death? If this is the case, then the person has no chance of recovery, the damage is irreversible and according to UK law, the person has died. When the brain stem stops working, the brain cannot send messages to the body to control our unconscious functions, and equally cannot receive messages back from the body. Medical treatment may help to limit the build up of pressure but it is not always possible to stop or reverse this. This pressure and swelling causes death by a process called ‘coning’ where the brain is forced through a small opening at the base of the skull where it meets the spinal cord. Pressure then builds up and causes a decrease in blood flow as well as damage to the tissues. Regardless of the cause the brain responds to injury by swelling and unlike other areas of the body there is little room for expansion inside the closed skull. The brain stem can stop working for a number of reasons for example, when other areas of the brain are affected by trauma, bleeding, infections or tumours. The brain stem is at the very bottom of the brain and controls many functions vital to life such as consciousness, awareness, breathing and the ability to regulate heart rate and blood pressure.
The other is cardiorespiratory death, and is when breathing and circulation has stopped. Coronavirus (COVID-19) – information for children, young people and familiesĬoming to GOSH for a day or inpatient admissionĬoming to GOSH for an outpatient appointmentīrain stem death is one of the two ways doctors can certify someone, either an adult or a child, as having died.
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