Devastating Brain Injury and Brain Death

Curriculum Reference

12.14.11 Liaises with transplant services when appropriate, can perform Brian stem death testing and provides the physiological support of the donor.

12.14.10 Manages end of life care within the intensive care environment with patients, relatives and the multi-professional team.

13.2.2 (B) Applies legal and ethical guidelines to their medical practice, including the legal requirements of consent and shared decision making.

14.14.2 Explains the physiological and pharmacological requirements for the clinical management of the patient for organ donation.

HiLLO 8: Doctors specialising in Intensive Care Medicine will understand and manage the physical and psychosocial consequences of critical illness for patients and their families, including providing pain relief, treating delirium and arranging ongoing care and rehabilitation. They will also manage the withholding or withdrawal of life-sustaining treatment, discussing end of life care with patients and their families and facilitating organ donation where appropriate.

National Guidance/Standards

Academy of Medical Royal Colleges: A code of practice for the confirmation and diagnosis of death

Management of perceived devastating brain injury after hospital admission: a consensus statement from stakeholder professional organizations

FICM Form for the Diagnosis of Death using Neurological Criteria – Short Version (including ‘Red flags’ on diagnosing death with neurological criteria)

NHS Blood and Transplant: Diagnosing death using neurological criteria

The RCP clarifies its position on assisted dying

Royal College of Physicians Prolonged disorders of consciousness following sudden onset brain injury: national clinical guidelines

RCoA Audit Compendium

FICM Standard

Declaration of death by neurological criteria must be conducted as per the Academy of Medical Royal College’s Code of Practice.

FICM recommendation

Management of patients with prolonged disorders of consciousness should follow national guidance.

Patients with perceived devastating brain injury should be admitted to the critical care unit to aid prognostication as per national guidance.

The use of cerebral computed tomographic angiography as an ancillary investigation to support a clinical diagnosis of death using neurological criteria: a consensus guideline – Thomas – Anaesthesia – Wiley Online Library

Ancillary testing and when to do it, 2023 guide

NACCS Webinars & Video