I was reading some comments about nurses talking to Brain Dead Patients and one stood out to me from NeuroICU RN and i quote "Ok Mandy....first of all the reason I quoted you was this. If someone is brain dead, then they are dead. Completely dead. Bought the farm. It is no different than if they are asystolic. At the point of brain death, organs may be harvested. Just because the heart has not stopped does not mean they are still alive. So there is no "coming back" from that. However, yes, patients may come back from a comatose state. But honestly, I have yet to ever see one that remembers things from the comatose state.
Now back to the subject at hand. Yes, I do talk to my patients. I don't think I have to explain why I talk to the alive and comatose ones. I don't always talk to the brain dead ones. As for why I occasionally talk to the brain dead ones....well, I guess it's more of a habit. You know, as an ICU nurse, you just get used to talking about what you're doing as you do it. But I don't talk to them as if they were alive....because they're NOT!
As for the ICU educator who always corrects students for doing that...well that's wrong. She should educate them that brain death IS death, but if they want to talk to the patient, then that is their right...no matter what their motive may be.
Also....no, the (true) definition of brain death does not vary from place to place....the term is just misused at times!
I've probably already done more brain death criteria testing in my short career in nursing, than other nurses have in 30 years!!! So if anyone has any questions, please feel free to ask."
And the part I want to address is "At the point of brain death, organs may be harvested. Just because the heart has not stopped does not mean they are still alive. So there is no "coming back" from that."
That is absolutely 100% false. My father is in the hospital now 4/15/2018 he went in this past Thursday and he was said to be brain-dead meaning there was no brain activity whatsoever according to the EEG. They gave him 72 hours on life support but before the 72 hours hit has regain brain activity.
Your brain is with tells you to breathe, your brain is with tell your heart to keep beating your brain is what tells every function in your body to continue to do what it's supposed to do. And no we don't know everything about the brain and to assume that a person who is brain-dead supposedly and can not come back that is close-minded and wrong because they can. The field of Medicine continually advances and new technology comes out and new discoveries come out and so as far as the brain they're still discovering things about the brain you still don't know everything about the brain.
So to conclude the original question that was asked should you talk to brain-dead patients I think you should because it's not a definite answer to whether or not they are living or dead as far as the brain because we don't really know for sure.
While there are basic elements in the determination of brain death, actual diagnosis of brain death varies from institution to institution, ie, brain death in one place may not be brain death in another.
Ok. According to Aopo( Association of organ procurement organizations)
Background: In 1980, the National Conference of Commissioners on Uniform State Laws (NCCUSL)* issued the Uniform Determination of Death Act (UDDA). Acknowledging that advances in medical technology had changed the ways in which death could be determined, UDDA specified that death be determined by both traditional respiratory and circulatory criteria and by the newer neurological (brain death) criteria. Brain death is now incorporated in the law of every state and most of these laws are based on UDDA. UDDA provides that:
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. A determination of death must be made in accordance with accepted medical standards.
This is how brain death is determined in every state.
I'm sorry to hear about your father.
I don't think anyone should be discouraged from speaking to a brain dead patient. I think nurses recognize it's more for their own comfort than patient comfort at that point.
If this topic is of interest to you, I would recommend reading about cardiac automaticity. The brain is not responsible for a person's beating heart; the heart is. That's why either brain death or cardiac death both qualify as someone being legally dead.
As an Administrator and nurse I have been known to sit and talk to the person who expired...died. I say my goodbyes. If anyone corrected me I would not listen to them. I talk to my dogs, my cat and my hennies and plants too. Talking to a body is respectful to the dead patient, to their family and to yourself.
I know this is older, but where are EEGs used in determining brain death? Brain death should be determined by two different things, an apnea test and brain flow study.
I've just seen on this site mentioning EEGs before and I've never heard of them used in determining brain death.
In response to the above post, I totally agree. An EEG should never be use as the only confirmatory test for brain death. I live in CA and the EEG is usually used in conjunction with an 4 vessel cerebral angiogram, a radionuclide blood flow study, and a Doppler US.
Last edit by Delia37 on Aug 3
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