Now, one wouldn't nesscessarily negate the other, I would think...someone could have a spinal cord injury, c1-c2, and also be 'brain dead', couldn't they?
And RBBM: We've just seen SunnieRN, who is an RN and a longtime poster, say that MRI's are not used to confirm brain activity, so to speak...may I ask, where you get your info from?
Hi Paladine. I have been an RN for 19 years and done many types of nursing. When I was an ICU manager, we had a wonderful neurologist on staff. We had a young man, 25, who tried to commit suicide. He was brain dead. The Doctor took a lot of time with the family, explaining how he came to the conclusion.
First, normally, there are MRI's and CT's done. These determine if there are bleeding in the brain, injuries that have occurred, and most important if and the amount of swelling of the brain tissue, etc. CT's can be in color, showing the difference between arterial and venous blood sources also.
There also has to be observation of the pt and his reactions. If a patient is sedated, due to being on a ventilator, or has other medications, such as narcotics on board, they have to give those a chance to wear off, so they can make a true assessment of the patients abilities.
The best possible way to determine if the brain is functioning is an EEG. It is the 'gold standard', for lack of a brain that was working for 13 hours last night. I am more than a little bit fried, so forgive me.
You can observe and do as many tests as possible, but without an EEG, there is not actual proof of brain death.
A person can suffer a high C-Spine injury and not be brain dead, , below C-2, but will not be able to have anywhere near a normal existence. No movement, can not breathe on their own without the ventilator, etc.
Some doctors say that a prolonged vegetative state is the same as brain death. I happen to disagree, for personal reasons and beliefs. If there are brain waves and a person is breathing on their own, I don't believe they are brain dead.
Our minds are strange and wonderful things. They are only understood at a very small degree.
When I was in nursing school, I had a patient that had experienced a major brain stem infarct, (stroke), three years previously. He was still in a hospital, vs a rest home due to the fact that he had so many communicable diseases, so no long term facility would take him. He was non communicative. The family believed that the patient was trying to communicate with them, the nurses and doctors told them he was not, that he was brain dead and was a 'vegetable'. The family refused to stop his feedings, antibiotics or care.
Here I come, a second semester nursing student and I didn't know jack. I got assigned this patient. I went in, fully garbed, gown, mask, shield, booties, gloves. I am a 'talker' and usually know everything about my patients by the time I go home. So, I talked TO this man. Not about him. I was doing a visual assessment, taking notes for my research and prep to care for him the next day.
I talked the entire time. About his tennis shoes, the weather, his curly hair, the fact that he had a wonderful jaw line. You get the picture. This man had a G tube, a foley, central lines, bi pap and more. Long assessment on both sides of the bed. I was watching him and he was 'listening' to me. Trying to 'see' me. I went and told his nurse that I felt like he was trying to communicate with me. She told me I was crazy. She called my instructor who came up and yelled at me about how dumb I was and that she would personally make it her job to get me kicked out of the program.
The hospital social worker heard me, came to talk to me after, asked if I really felt like he was trying to communicate. I said 'yes'. She said, do your research, find out what you think we could do to communicate with him.
I went home, talked to my friend. She shouts, "Oh my God, you have to read this readers digest article I have. It describes your guy!"
I went and got the magazine, read it and the person in the article had 'locked in syndrome'. It is a condition where the brain is so damaged that you can't talk, you can usually not purposely move many parts of your body, but you are aware of EVERYTHING!!!!
I talked to the social worker the next morning. I actually got through the day, even though everyone, including my fellow students, thought I was crazy.
The social worker worked with the patient after I left. She brought a letter board into his room. She talked to him and tried to see if there was a way for him to communicate. He could barely move his right index finger.
It took four hours, but the first thing he spelled out was, "tell the nurses to stop coming in my room and telling me I should be dead'.
That is why family members have hope. Because miracles DO happen!!
I have no idea what happened to Maxie or about his actual diagnosis. I don't think he 'died' as they were waiting to make decisions until after the MRI. I just have a funny feeling about things from what I have heard. Not enough information yet, to make a valid determination, but something seems very 'off'. Where was the grieving, angry, denying parent? Did Maxie see every kind of specialist possible? Things in hospitals are often long and drawn out, unfortunately. Also, if he 'just died' they wouldn't have been able to do organ donation. He was still on life support since that happened.