What is

Examining for Brain Death

IN MINUTES

Ushers 11-year-old stepson was declared brain dead after a jet skiing accident on Saturday. Doctors must rst do a series of tests to be able to come to this conclusion.
The examination for brain death is based on response to external stimuli. Since the brain is the organ that feels outside pain, when the brain is dead the patient feels nothing. Before the examination is performed, the physician will have a toxicology test performed to make sure the patient does not have any muscle relaxants in his system, and will check that the patient's body temperature is not extremely abnormal, either of which may reduce neurological reexes.
MOTOR

BRAIN DEAD?
1 1
3 pounds
The brain

News and events visually

A human brain weighs about

SENSORY BROCHA (motor speech)

PARIETAL LOBE (movement)

cannot feel pain

Positive Examination

The positive examination for brain death includes the following tests: NO RESPONSE TO COMMAND Verbal, visual or otherwise NO MOVEMENT
The arms and legs are raised and allowed to fall to see if there is restraint or hesitation in the fall.

75%
OCCIPITAL LOBE (vision) TEMPORAL LOBE (language)

The brain is made of 75% water There are over

PUPILS ARE UNREACTIVE (FIXED)

A very bright light is shined into the pupil to activate the optic nerve and tell the eye to constrict the pupil.

NO CORNEAL REFLEXES

of blood vessels in the brain Information in your brain travels at more than

160,000 kms

A cotton swab is dragged across the cornea while the eye is held open. The intact brain will want the eye to blink.

NO OCULOVESTIBULAR REFLEX

While holding the eyes open, ice water is injected into the ear canal. The drastic change in ear temperature will cause a violent eye twitching by the intact brain.

418 km/h

NO GAG REFLEX

Stimulation of the pharynx will cause a gag reex in a comatose patient, but not in the brain-dead patient.

BRAIN STEM (body basics)

NO STIMULATION RESPONSE

NO OCULOCEPHALIC REFLEX

20% of the total oxygen in your body

Your brain uses

The patient's eyebrow ridge is compressed with the thumb. The resulting stimulation pressure will cause motion of the extremities in the living-brain patient.

The patient's eyes are opened and the head turned from side to side. The active brain will allow a roving motion of the eyes; the non-functional brain will not.

NO SPONTANEOUS RESPIRATION

The patient is temporarily removed from the ventilator. The body will immediately start to build up metabolic waste of CO2 in the blood. When the CO2 level reaches a level of 55 mm Hg, the active brain will cause the patient to breathe spontaneously. The dead brain gives no response.
SUSAN BATSFORD, GRAPHICS EDITOR, TWITTER @SBATS1; INFOGRAPHIC BY TARA CORRAN/QMI AGENCY

Sources: HowStu Works; www.nursingassistantcentral.com; www.savingthebrain.com; Acoustic Neuroma Asssociation; brainwaves.com