Brain death
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Brain death
People bring brought back to life from brain death.
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Alabama Child Protective Services Steals New-born Breast-feeding Baby from Rape Victim While Still at the Hospital

Alabama Child Protective Services Steals New-born Breast-feeding Baby from Rape Victim While Still at the Hospital | Brain death | Scoop.it
Juda Myers of Choices4Life calls her a "Hero Mom." A 14 year old Alabama girl became pregnant from a rape, but she courageously chose life for the baby that was
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Judge rules OK to stop ventilator for 10 minutes - Melissa Caulk on Brain Death

Judge rules OK to stop ventilator for 10 minutes - Melissa Caulk on Brain Death | Brain death | Scoop.it
Mirranda Grace Lawson I spoke to the parents, (Patrick and Allison Lawson) of Mirranda Grace by phone several weeks ago, right after Mirranda had been on life support due to choking on a piece of popcorn. A friend of mine from W. Virginia contacted me. I was able to connect them to Dr. Paul Byne to help …
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Trial starts to bring ‘dead’ 27-year-old car crash victim back to life

Trial starts to bring ‘dead’ 27-year-old car crash victim back to life | Brain death | Scoop.it
Trial starts to bring ‘dead’ 27-year-old car crash victim back to life https://t.co/OU3nM3LoPf
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Biotech Companies Given Green Light to Attempt to Regenerate Brains of the Dead

Biotech Companies Given Green Light to Attempt to Regenerate Brains of the Dead | Brain death | Scoop.it
Neuroscience News has recent neuroscience research articles, brain research news, neurology studies and neuroscience resources for neuroscientists, students, and science fans and is always free to join.
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Incredible Stories of Coma Patients

Incredible Stories of Coma Patients | Brain death | Scoop.it
Comas are some of the most incredible medical mysteries that exist. Check out these amazing stories of people who woke up from comas,...
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This Happens Everyday When People Sign The Organ Donor Card -

This Happens Everyday When People Sign The Organ Donor Card - | Brain death | Scoop.it
This Happens Everyday When People Sign The Organ Donor Card This is the story of Barbara Radcliffe from Vermont, who recently lost her son, Robert Strain. He most recently was employed as an instructor with the McKinney High School Color Guard as a choreographer. Barbara posted her story on a Facebook group I belong to called …
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The lie must end. 

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Is it Time to Pull the Plug on "Brain Death"?

Is it Time to Pull the Plug on "Brain Death"? | Brain death | Scoop.it
“Brain death” is simply too loaded with reductionist tendencies and should be changed to respect societies’ discomfort with the mind/brain/soul distinction in order to promote greater unders...
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The upshot of all this is that the term “brain death” is simply too loaded with reductionist tendencies and should be changed to respect societies’ discomfort with the mind/brain/soul distinction in order to promote greater understanding and acceptance of death among the general public.

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Dr. Paul A. Byrne: a man on a mission

Dr. Paul A. Byrne: a man on a mission | Brain death | Scoop.it
Breaking news, headlines and analysis from around the world.
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The hospital stated publicly that Jahi’s body was only remaining warm because they had a warming blanket on her. Dr. Byrne says that after she was removed from the hospital, Jahicontinued to be warmed first by three blankets, then two blankets, then only one blanket is all she now needs to keep warm. Her body is doing its work. She is receiving nutrition and medications.

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Miraculous Moment 16-Year-Old Boy Wakes Up After 4-Month Coma and Hugs Father

Miraculous Moment 16-Year-Old Boy Wakes Up After 4-Month Coma and Hugs Father | Brain death | Scoop.it
Missy Mullen Caulk's insight:

Why is it the UK publishes these stories and the US does not. They still say no one wakes up from brain death. 

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Acupuncture Wakes Up Coma Patients - New Research [798] | Acupuncture Continuing Education News | Acupuncture News

Acupuncture Wakes Up Coma Patients - New Research [798] | Acupuncture Continuing Education News | Acupuncture News | Brain death | Scoop.it
Acupuncture has been proven to wake up coma patients and improve neurological recovery.
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Woman Opens Eyes Before Organs are Harvested - Melissa Caulk

Woman Opens Eyes Before Organs are Harvested - Melissa Caulk | Brain death | Scoop.it
Woman opens eyes before organs are harvested. Yesterday the Associated Press published a post in the Wall Street Journal, titled NY Hospital Nearly Took Organs from Living Woman. SYRACUSE, N.Y.
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Dr. Paul Byrne in Leominster

Dr. Paul Byrne in Leominster | Brain death | Scoop.it
On Sunday night I attended a presentation by Dr. Paul Byrne concerning Organ Transplants and "Brain Death" The Doctor has impressive credentials: Interestingly enough there is an article at the BBC...
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Surviving traumatic brain injury: How some patients thrive after trauma

Surviving traumatic brain injury: How some patients thrive after trauma | Brain death | Scoop.it
NBC’s chief medical editor Dr. Nancy Snyderman profiles two patients who miraculously survived severe brain trauma and defied the odds with their amazing ability to relearn how to live.
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If they treat right, they can leave the hospital 

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Hospital Puts Teenager on Fast Track to Medical Termination - Christian Newswire

Hospital Puts Teenager on Fast Track to Medical Termination - Christian Newswire | Brain death | Scoop.it
Life Legal seeks medical personnel willing to provide independent evaluation . . . Contact: Allison Aranda, Life Legal Defense Foundation, 707-227-6744, akaranda@lldf.org LOMA LINDA, Calif., June 15, 2016 /Christian Newswire/ -- 13-year-old Alex Pierce, brain-damaged in Loma Linda Medical Center, faces tests and medical rulings that may end his young life. His family is desperately seeking a physician or hospital to conduct an independent evaluation of Alex's condition. If you know of me
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The Brain That Wasn’t Supposed to Heal

The Brain That Wasn’t Supposed to Heal | Brain death | Scoop.it
Steve Mishkin's unexpected recovery is a case study in luck, split-second decisions, and the many, many things that need to go right for a trauma patient to get well.
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Lazarus trial hopes to REVERSE death: 'Reanimation' firm gets 'ethical' approval to bring brain-dead people back to life

Lazarus trial hopes to REVERSE death: 'Reanimation' firm gets 'ethical' approval to bring brain-dead people back to life | Brain death | Scoop.it
The Philadelphia-based Bioquark project has gained approval from regulatory bodies for the first stage of its trials.' The resurrection of Lazarus in the Bible is illustrated.
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Not All Hospital Brain Death Policies Comply With Guidelines

Not All Hospital Brain Death Policies Comply With Guidelines | Brain death | Scoop.it
Not All Hospital Brain Death Policies Comply With Guidelines

Pauline Anderson

December 30, 2015
 
 

Not all hospitals in the United States are following guidelines on determining brain death, a new study suggests.

Researchers found a wide variation in terms of incorporating the updated 2010 American Academy of Neurology practice parameters (AANPP) into hospital policy.

Although "policies appear to be more congruent this time around," compared with when the researchers studied this in past years, "they are not 100% compliant" with guidelines, said lead author David M. Greer, MD, professor and vice-chair, neurology, Yale University School of Medicine, New Haven, Connecticut.

 
 
Dr David M. Greer

"We still have work to do," Dr Greer toldMedscape Medical News. "It's really important that policies be in line with national guidelines, which we created to make sure that there was no misdiagnosis. This is one of those diagnoses where we need to be correct 100% of the time."

The new study was published onlineDecember 28 in JAMA Neurology.

The updated 2010 guidelines provide clear step-by-step instructions, including a detailed checklist for accurate and consistent determination of brain death, specifically prerequisites, clinical testing, ancillary testing, and documentation.

"Our hope was that people would take this checklist, incorporate it into their policies and whammo, you would have a very good stringent policy that people could walk through very easily to make sure this is done correctly," said Dr Greer.

The new study included hospital policies from 492 hospitals or healthcare systems with adequate data for analysis, representing those from all 50 states (some analyses included 491 policies).

Of the total, about a third of policies (33.1%) required specialist expertise in neurology or neurosurgery, but 150 policies had no mention of who could perform the determination. Many policies still allow for more junior physicians to determine brain death, the authors noted.

Training Important

For Dr Greer, it's not the type of specialist that's important but the training. "I'm a firm believer that the person or people who are doing this need to have expertise in this area. I've trained many intensivists, trauma surgeons, and pulmonary doctors to do this correctly, and I have seen many neurologists and neurosurgeons do it incorrectly."

 

In this analysis, the number of required examinations and the waiting period between each test varied. Most hospitals (65.9%) required two separate examinations to determine brain death, and 20.9% required more than two examinations; 13.0% required only one examination.

Dr Greer noted that some states require two examinations but one is acceptable, according to the guidelines.

Where more than one examination was required, 54.1% of policies specified a waiting period between examinations: 10.2%, less than 6 hours; 71.1%, at least 6 hours; 2.6%, at least 12 hours; and 1.1%, at least 24 hours.

Dr Greer pointed out that when there's a significant waiting period between examinations, organ donation rates may go down because people are less willing to consent and the viability of organs deteriorates.

"Our rule of thumb is, don't declare or even test the patient unless you are certain that there is no chance of reversibility. So if there's no chance of reversibility, a second test should not be necessary."

However, a "caveat" is in the case of cardiac arrest, where there is "clearly a chance for recovery of function after the patient initially looks brain dead," said Dr Greer. In the study, a specific waiting period for cardiac arrest was in 7.1% of policies that stipulated two tests, which was most commonly set at 24 hours or more.

Required Prerequisites

Most policies (93.5%) stipulated prerequisites before clinical testing. Of these protocols, 82.9% required that the cause of brain dysfunction be established and 94.3% required the absence of effect of specific medications, including sedatives alone, paralytics alone, or both.

 

Specific drug levels (for example, of barbiturates) were mentioned in 25.1% of policies and absence of paralytic effect measured by peripheral nerve electrical stimulation in 11.2%. Absence of hypotension was required by 56.2% of protocols and patient temperature of at least 36°C by 79.4%. The new guidelines recommend a minimum body temperature of 36°C, Dr Greer noted.

With regard to required clinical examinations, Dr Greer noted that some policies didn't stipulate testing of lower brainstem function. "They are very good at making sure that pupillary reflexes and corneal reflexes are absent, and that there's coma — at 90% or 95%, that's pretty darn good — but when it comes to the cough reflex, which is a lower brainstem reflex, less than 80% of the policies stipulated that that needs to be absent, and we feel that is a core feature."

Why did some policies consider certain tests to be more important than others? "Perhaps people think, 'I have to check pupils and corneas and make sure they're in a coma,' but maybe they aren't thinking as much about checking for cough or gag or reaction to deep pain. These are all relatively easy to check, but may not all be at the tip of the tongue or front of mind for people doing the testing."

Most hospitals (97.4%) required apnea testing, with 66.4% specifically stipulating arterial blood gas measurements before initiation of testing for apnea and 59.1% delineated the appropriate baseline PCO2level.

However, some policies didn't specify the requirement of the final PCO2 100% of the time. "This really needs to be specified," stressed Dr Greer.

A majority of policies (57.2%) recommend maintaining oxygenation by a cannula placed within the endotracheal tube. The specific number of liters per minute of oxygen supplied during the apnea test was overtly stated in 63.1% of policies.

 

According to the authors, hospital policies often lack the specifics of approved ancillary testing. And sometimes, policies include unapproved and/or nonvalidated ancillary tests.

Unproven Tests

"MRI and CT [computed tomographic] angiography are tests that are popular now but not proven, and there have been false positives with those tests," said Dr Greer. "We feel it's very important that those don't creep into the guidelines without having gone through a proper vetting process."

Although he knows of no documented report of patients regaining brain function after being declared brain dead, Dr Greer has heard anecdotally about proper protocols not being followed and patients being "mispronounced" and regaining some function.

Dr Greer said he hopes his paper will "light a fire" under hospitals to get them to ensure their brain death policies are "congruent" with updated guidelines. One way to get better compliance, he said, is to make it part of hospital accreditation.

A brain death "tool kit," including a sample checklist, is available on the Neurocritical Care Society website.

 

Reached for a comment, Gene Sung, MD, past-president, Neurocritical Care Society, and director, Division of Neurocritical Care and Stroke, Keck Medical School, University of Southern California, Los Angeles, said one of the most concerning "gaps" uncovered by the study was the number of policies that don't mention the qualifications needed for those determining brain death.

"It could be people who have no experience at all, and they're doing something important like saying if someone's alive or death," he told Medscape Medical News. "That's very concerning."

Those determining brain death may not even have heard of the new guidelines, even though they've been out for more than 5 years, said Dr Sung, who is working with the World Federation of Societies of Intensive and Critical Care Medicine to try to standardize brain death determination worldwide. Outside the United States, that is "an even bigger issue," he said.

Another of Dr Sung's concerns is that if there's such variation in what's written into a hospital brain death policy, how much more variation is there in what doctors are actually doing in practice.

"The concern is that the written policies don't even match the guidelines, and so then, are doctors actually even following them."

Dr Sung agreed that there have been no documented reports of regaining function after a declaration of brain death. "But still, we don't know for sure; maybe mistakes happened and they weren't reported," he said.

 

Although the study included information on fewer than 500 policies and there are over 5000 hospitals across the country, the institutions included in the study are probably the biggest and they deal with the issue of brain death the most, said Dr Sung.


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Woman defies science after being 'clinically dead' for 26 minutes

Woman defies science after being 'clinically dead' for 26 minutes | Brain death | Scoop.it
As an emergency room doctor of 25 years, Kurt Solem has treated it all. Yet his most recent patient, Debbie Biggles, is defying everything he learned in that quarter century.
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Love these miracles, especially when the doctors confirm it. 

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Organ Transplants Cellular Memory Proves Major Organs Have Self-Contained Brains?

Organ Transplants Cellular Memory Proves Major Organs Have Self-Contained Brains? | Brain death | Scoop.it
Organ transplants cellular memory is a premise which exemplifies that our brain is not the only organ that stores personality traits and memories because major organs may have self-contained brains...
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Jahi McMath--accepting her life

Jahi McMath--accepting her life | Brain death | Scoop.it
[The following Response to "Jahi McMath and Determining Death," Ethics and Medics 39(3) March 2014, was submitted to National Catholic Bioethics Center (NCBC) for publication, which was denied. Jahi McMath, a13 year old girl, is living and needs physicians, theologians, lawyers and others to stand up for her. This is about protecting Jahi and everyone, not only Catholics, but the NCBC has done nothing to protect or support Jahi, or anyone else in a similar condition.]
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Jahi is not truly dead, Wesley Smith

Jahi is not truly dead, Wesley Smith | Brain death | Scoop.it
Wesley Smith wrote about Jahi McMath, a patient in Oakland Children's hospital: "In Jahi's case, brain dead actually means a declaration of "death by neurological criteria," one of the two legal methods for declaring the bona fide death of a human...
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Melissa Caulk - Running Around in Circles...Changing Minds About Brain Death

Melissa Caulk - Running Around in Circles...Changing Minds About Brain Death | Brain death | Scoop.it
Running Around in Circles...Changing Minds About Brain Death
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Think you don't need an organ donor opt-out card? Think again -- the Burns case

Very few people look forward to going to the doctor. Even fewer look forward to being a patient in a hospital. Some people have an irrational fear of hospitals. This is not a good thing.
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Dr. Paul Byrne says it so well. 

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» The Danger Of “Non-Brain Death” Organ Donations - Blogger News Network

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Good post 

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Grief Is Not A Disease

Grief Is Not A Disease | Brain death | Scoop.it
After my fiance, Dan, committed suicide, my grief became extreme. None of the people around me understood my grief, including myself. Most of the people I knew had very little experience with the g...
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I've heard most of this, or seen it in their eyes. 

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