This can be accomplished by history, drug screen, etc. ![]() One has to exclude the presence of any drugs or poisoning in the system. The extracranial cause of brain death is most commonly cardiopulmonary arrest with inadequate cardiopulmonary resuscitation. ![]() However, in children, the most common cause is non-accidental trauma. Intracranial injuries leading to brain death in adults are most commonly traumatic brain injuries or subarachnoid hemorrhage. First, we have to establish an acute and irreversible cause. In adults and children, the precipitant of brain death is either from an intracranial or extracranial cause. The AAN defines them as “coma (with a known cause), the absence of brainstem reflexes, and apnea.” īrain death occurs after the destruction of enough neuronal cells in the brain that there is both an irreversible loss of consciousness (coma) and the absence of brainstem reflexes, including the inability of the lungs to inhale and exhale without external positive pressure support (apnea). īased on the published standards, three findings must be present to establish brain death. The American Academy of Neurology (AAN) published the most current standards in 1995 and then updated them in 2010. Unfortunately, the UDDA did not go on to establish what “accepted medical standards’ were, only that they existed. A determination of death must be made in accordance with accepted medical standards.” This act reads as follows regarding “Determination of Death: An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. ![]() The act was drafted in response to medical advances in life support in the late 1970s that allowed for complete respiratory and circulatory support despite the complete cessation of brain function. These criteria were later adopted by the American Medical Association and the American Bar Association. The term has been present in medical literature and texts for many years, but as part of the National Conference of Commissioners on Uniform State Laws in 1980, the Uniform Determination of Death Act (UDDA) was drafted. Brain death is both a legal and clinical term.
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