Test Pupillary Reflex Corneal Reflex Caloric (Oculo-vestibular) Reflex Painful Stimulation Gag Reflex Cough Reflex Procedure A bright light is shone into each eye in turn. Direct and consensual reflexes should be sought Cornea is brushed lightly with a swab with care...
Coma Specific criteria are laid out in guidance from the AOMRCMetabolic or endocrine disturbanceCirculatory disturbanceSedative/depressant drugsHypothermia Apnoea Rare but should be actively sought if the history or clinical examination suggests their presenceSevere...
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...
Testing should be performed a minimum of 6 hours after loss of last brain stem function Longer period should be given in atypical presentations: A minimum of 24 hours should be given if primary aetiology hypoxic brain injury Prolonged observation may be required in...