Irreversible Death Determination

Brain Death Determination

When the brain has a lack of oxygen, even for a few minutes, it could lead to loss of brain functions such as a gradual loss level of consciousness or a complete loss of consciousness causing the person to slip into a coma. In the most profound cases, irreversible brain damage and death occurs. Oxygen deficiency can by caused by many things, such as; a brain injury, fall from height, traffic accidents, heart failure, stroke or some neurological disease. That may cause irreversible loss of the brain cells performance. The medical term for insufficient oxygenation to the brain is cerebral anoxia. Historically, before recent technology the scientists defined death only when the heartbeat and breathing stopped. Afterward,
This exam has a specific protocol to perform it, such as an increase the inspired fraction of oxygen without changing the ventilation rate, disconnect the patient from the ventilator for 10 minutes and supply a continuous flow of humidified air. These procedures are done to detect if there is any attempt for the patient to breathe (ibid). Another test that is sensitive in analyzing the circulation in the brain is transcranial Doppler (TCD) this examination detects the velocity of the blood that’s circulating in the blood vessels supplying oxygen-rich blood to the brain. It uses ultrasonic waves that are focused into a beam that is directed at different depths and angles by an experienced operator. The technologist uses sites on the skull where the bone is relatively thin and relatively close to the major vessels whose blood flow velocities are critical. One major vessel that supplies the brain is the Middle Cerebral Artery (MCA). When the blood flow circulation is compromised to the extent that survivability is not possible the TCD shows reverberating waveforms as the blood ceases to flow in it’s normal direction and instead is ineffectually regurgitating back and forth without flow in response to the heart contraction. Later there are systolic spikes that indicate some increased pressure in the vessel with heart contraction but without effective flowing of blood through the
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