Which situations should be ‘red flags’ to diagnosis of irreversible brain damage?

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

D