Brainstem death testing in the UK--time for reappraisal?
BACKGROUND
A diagnosis of brainstem death in the UK is based on clinical assessment rather than technical investigations, but is considered rigorous enough to be legally synonymous with death.


METHODS
A questionnaire in five sections concerning clinician details, initiation of support, criteria for testing, conduct of the tests, and the process of organ donation, was sent to all members of the Neuroanaesthesia Society.


RESULTS
The survey reveals evidence of failure to apply existing guidelines accurately and a wide variation in practice where the recommendations are not specific.


CONCLUSIONS
In an era of scrutiny of medical process, it is timely to consider whether the current guidelines should be revisited. Clarification of the approach to biochemical derangement, and the role of confirmatory tests when the residual effect of sedative agents cannot be excluded, are two areas worthy of debate.
Bell
M D D
MD
Department of Anaesthesia and Intensive Care, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK. dominic.bell@leedsth.nhs.uk
Moss
E
E
Murphy
P G
PG
D001926:Brain Death / Q000175:diagnosis*; D003943:Diagnostic Techniques, Neurological; D019983:Guideline Adherence / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D017410:Practice Guidelines as Topic; D011364:Professional Practice / Q000706:statistics & numerical data*; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D009927:Tissue and Organ Procurement; D006113:United Kingdom