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Brain Death by Neurological Criteria Examination

EBM

February 1st, 2012 - February 16th, 2015
1.00 AMA PRA Category 1 Credit™ Hours

Description

Brain death is the irreversible loss of all function of the brain, including the brain stem. The three essential findings in brain death are coma, absence of brain stem reflexes, and apnea. The American Academy of Neurology recently released new guidelines for determining brain death in adults. Updated for the first time in 15 years, the recommendations provide step-by-step instructions to help guide clinical decision making.

To correctly diagnose brain death, it is essential that clinicians adhere to a uniform framework. An interdisciplinary team of clinical experts worked together to provide a useful summary guide and tools to help clinicians at OSUMC, but many factors will still need to be based on clinical judgment.

Diagnosis must be done by a physician who has the necessary skills and experience in diagnosing brain death.  Therefore, the group agreed that brain death determination must be confirmed by an attending physician who is a neurologist, neurosurgeon, or critical care specialist. It was recommended that these services establish a process for identifying and privileging physicians to make brain death determination.

Since the application of the clinical criteria described in the guideline requires the judgment of a physician competent in determining brain death, it is expected that physicians in these departments will complete a training session to ensure ongoing competency. 

Additional information concerning brain death by neurological criteria examination may be obtained by reviewing the following article: 

Evidence-based guideline update: Determining brain death in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology

Eelco F.M. Wijdicks, Panayiotis N. Varelas, Gary S. Gronseth, et al. Neurology 2010;74;1911     DOI10.1212/WNL.0b013e3181e242a8

To access the entire article, please use the following link: http://www.neurology.org/content/74/23/1911.full.html

The overall learning objectives for the Evidence-Based Medicine (EBM) Enduring Materials Series are:

  1. Describe 5 best clinical practice recommendations associated with each guideline. 

  2. State 2 quality outcome measures associated with each guideline.

  3. Identify order sets, policies / procedures, and patient education resources associated with each guideline.

  4. Identify key national guidelines and/or references associated with each guideline.

Planning Members Disclosures

The following planning committee members have no relevant financial relationships with commercial interests to disclose, their educational unit does not have a financial interest or affiliation with an organization that may receive direct benefit from the subject of the proposed CME activity, and they will not be personally compensated for their role in the planning or execution of this proposed CME activity by an organization other than The Ohio State University:

Leisl Ashbaugh, Belinda Bardall, Diana Greene - Chandos, Amy Pope-Harmon, Robert Taylor, Andrew Slivka, Anne Smith, and Anne VanBuren.  

Speaker Disclosure

The following speaker for this program has no relevant financial relationships with commercial interests to disclose, and her presentation will not include discussion of unapproved or “off-label” usage of commercial products and/or devices:

Diana Greene-Chandos, MD

Special Note: This enduring material was reviewed and updated on Feb. 16, 2014.  The updates to this enduring material are listed below:

Changes to this education:
  1. Included the new requirement that brain death can by only declared by the attending physician who is a Neurologist, Neurosurgeon, or Critical Care specialist and who has successfully completed the Core Privilege on “Determination of Brain Death”
  2. Quality measure was added regarding the necessity to have only those that have successfully completed the Core Privilege on “Determination of Brain Death”  declaring brain death in patients
  3. Edited the organ donation information to only include Lifeline of Ohio



The Enduring Material is no longer available.

Dates and Times

End Date: 2/16/2015

Objectives

At the conclusion of this Brain Death by Neurological Criteria Examination activity, participants should be able to: DESCRIBE 5 key recommendations associated with Brain Death Determination guideline. STATE 2 quality measures associated with Brain Death Determination guideline. IDENTIFY policy and documentation requirements associated with Brain Death Determination guideline. IDENTIFY key national guidelines and/or references associated with Brain Death Determination guideline.

Internet Enduring Material Files

File Link

OSUMC Brain Death Policy

 Download

Guideline - Medical Center Evidence Based Medicine

 Download

Speakers

  • Diana Greene-Chandos, MD
    • Brain Death by Neurological Criteria Examination

Accreditation Statement

The Ohio State University is accredited by the Accreditation Council for Continuing Medical Education (ACCME®) to provide continuing medical education for physicians.

AMA Credit Designation Statement

The Ohio State University designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.