Traumacast Brain Death Testing
Nov 1, 2025
Dr. David Fischer, a neurointensivist at the University of Pennsylvania, and Dr. Matthew Kirschen, a pediatric neurointensivist at the Children's Hospital of Philadelphia, dive deep into the complexities of brain death testing. They discuss the updated 2023 guidelines that unify adult and pediatric protocols, addressing the risks of incorrect determinations and the importance of rigorous training for clinicians. Key topics include the role of family consent, the challenges of assessing brain death in specific cases, and the intricacies of apnea testing.
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Definition Of Brain Death
- Brain death is medical and legal death defined as permanent loss of all brain functions including brainstem reflexes and respiratory drive.
- The diagnosis is clinical and requires coma, brainstem areflexia, and absent respiratory drive with adequate stimulus.
Unified Adult And Pediatric Guidelines
- The 2023 guideline unifies adult and pediatric guidance to make death determination age-independent.
- It updates prior recommendations to reflect advances like ECMO and therapeutic hypothermia.
Require Training And Follow Local Law
- Ensure clinicians have formal training before performing brain death testing and use a hybrid of virtual and in-person modules.
- Follow state laws and institutional policy about who may perform determinations.