1/
Patient found down and intubated in the field. Pupils non-reactive, no cough, no gag, no movement.
#neurotwitter #braindeathtesting #neurology #neurotwitternetwork #medstudentwitter #medEd #FOAMncc
Patient found down and intubated in the field. Pupils non-reactive, no cough, no gag, no movement.
#neurotwitter #braindeathtesting #neurology #neurotwitternetwork #medstudentwitter #medEd #FOAMncc
2/ Would you proceed with brain death testing?
3/Remember, for a patient to be appropriate for brain death testing, they must have clinical and radiographic evidence for WHOLE brain death. Like this:
4/ This case emphasizes how that doing brain death testing the right way on the right patient is one of the single most important things in neurology and critical care!
It’s also tough to think through all the steps and remember all the confounders -- we’re with you!!
It’s also tough to think through all the steps and remember all the confounders -- we’re with you!!
5/
Which is why its so crucial to have a #cheatsheet and framework for #braindeathtesting (below!)
1st some pearls:
⭐️ Confirm whole brain involvement (not just brainstem!)
⭐️ Rule out medical confounders
⭐️ Perform clinical exam
⭐️ Proceed to apnea testing if appropriate
Which is why its so crucial to have a #cheatsheet and framework for #braindeathtesting (below!)
1st some pearls:
⭐️ Confirm whole brain involvement (not just brainstem!)
⭐️ Rule out medical confounders
⭐️ Perform clinical exam
⭐️ Proceed to apnea testing if appropriate
6/ For the clinical exam 💡
⭐️ Do not perform oculocephalic reflex in pt with cervical spine instability/trauma etc.
⭐️No cold calories if basilar skull fractures and "stuff" (I.e blood, brain matter) in ear
⭐️ Do not perform oculocephalic reflex in pt with cervical spine instability/trauma etc.
⭐️No cold calories if basilar skull fractures and "stuff" (I.e blood, brain matter) in ear
7/
Reminder: always consult your hospital policy, and that your patient may need medical optimization:
And that even if they are breathing over the vent, they still may meet criteria for testing:
Reminder: always consult your hospital policy, and that your patient may need medical optimization:
And that even if they are breathing over the vent, they still may meet criteria for testing:
8/
For everything else, here’s a #cheatsheat for optimization, the exam & apnea testing @emoryneurocrit!
Great overview here (@crit_care) doi.org
& @emcrit & @pulmcrit also have a great review on @ibcc:
emcrit.org
For everything else, here’s a #cheatsheat for optimization, the exam & apnea testing @emoryneurocrit!
Great overview here (@crit_care) doi.org
& @emcrit & @pulmcrit also have a great review on @ibcc:
emcrit.org
9/
For this and other #FOAMncc resources, check out
and @jimmysuh @caseyalbin @clhallmd @CajalButterfly @neuro_intensive @BIDMCNeuroRes @Capt_Ammonia @StefCappucci @mallyaa @JackieKraft4 @EricLawson90 @JenHarrisMD @DalalSidd @SydniCole17
For this and other #FOAMncc resources, check out
and @jimmysuh @caseyalbin @clhallmd @CajalButterfly @neuro_intensive @BIDMCNeuroRes @Capt_Ammonia @StefCappucci @mallyaa @JackieKraft4 @EricLawson90 @JenHarrisMD @DalalSidd @SydniCole17
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