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Absent respiratory response as PCO2 increases from 38 to 61 mmHg
5%
3/64
Temperature of 34 degrees Celsius
61%
39/64
Suspected irreversible cessation of brain function for 12 hours with an EEG
8%
5/64
Suspected irreversible cessation of brain function for 6 hours with an isoelectric EEG
14%
9/64
Urinalysis from the day of admission positive for opiates
11%
7/64
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This patient failed to regain consciousness after a cardiac arrest. Brain death cannot be diagnosed in patients that are hypothermic. Several criteria exist for determination of brain death in a patient. Although specific protocols vary by state and hospital, the absence of brainstem reflexes and respiratory response are cornerstones of the diagnosis. Importantly, brain death cannot be declared in the presence of hypothermia, shock, sedatives, or neuromuscular blocking agents. Incorrect Answers: Answer 1: Absent respiratory response with a PCO2 > 20 from baseline is consistent with brain death. Answers 3-4: Suspected irreversible cessation of brain function for 12 hours is consistent with brain death; if an EEG shows isoelectric activity, physicians must only wait 6 hours before making the diagnosis. Answer 5: Current use of sedatives, not past use of sedatives, prevents a diagnosis of brain death.
3.2
(6)
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