List 5 ‘red flags’ for when diagnostic caution is advised before making a diagnosis of irreversible brain damage?

  • Testing less than 6 hours of the loss of the last brainstem reflex 1
  • Testing less than 24 hours of the loss of the last brainstem reflex, where aetiology primarily anoxic damage 1
  • Patients with any neuromuscular disorders 1
  • Prolonged fentanyl infusions 1
  • Steroids given in space occupying lesions such as abscesses 1
  • Aetiology primarily located to the brainstem or posterior fossa 1
  • Hypothermia – a 24-hour observation period following rewarming to normothermia recommended 1
  • Therapeutic decompressive craniectomy 1
FFICM / ICS Guidance

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