Study on physicians and declaring brain death
A training study was completed at Yale University and conducted on the accuracy of physicians in determining brain death.
The study consisted of a didactic course and a simulation exercise, and was bookended by before and after multiple-choice tests.
- The 40-min didactic course, including a video demonstration, covered all aspects of the brain death examination.
- Simulation sessions utilized a SimMan 3G manikin and involved a complete examination, including an apnea test.
- Possible confounders and signs incompatible with brain death were embedded throughout.
- Facilitators evaluated performance with a 26-point checklist based on the most recent AAN guidelines.
- A senior neurologist conducted all aspects of the course, including the didactic session, simulation, and debriefing session.
Despite straightforward guidelines on brain death determination by the American Academy of Neurology (AAN), substantial practice variability exists internationally, between states, and among institutions. “Acceptable medical standards are not defined in the Uniform Determination of Death Act.
Ninety physicians from multiple specialties participated in the didactic session, 38 of whom have completed the simulation.
Results: Pre-test scores were poor (41.4 %), with attending physicians scoring higher than residents (46.6 vs. 40.4 %, p = 0.07), and neurologists and neurosurgeons significantly outperforming other specialists (53.9 vs. 38.9 %, p = 0.003).
Post-test scores (73.3 %) were notably higher than pre-test scores (45.4 %).
CONCLUSION:
Baseline knowledge of brain death determination among providers was low but improved greatly after the course. Our intervention represents an effective model that can be replicated at other institutions to train clinicians in the determination of brain death according to evidence-based guidelines.
Is 41.4% good enough for you if that was your loved one?
Is 73% good enough for you IF that was your loved one?
I have said before whenever someone wakes up from being declared brain dead the doctors ALWAYS say the test was done wrong. I guess this study published on April 2, 2014 confirms that point.
Why don’t they just admit brain death is a lie and concocted to promote organ harvesting???
