Now, we’ll move onto actual testing.
Here is the procedure for performing an apnea test.
1. The patient will be on an ECG and pulse ox monitor.
2. Give the patient 100% oxygen for five minutes.
3. After five minutes, disconnect the patient from the vent, but give oxygen via T-piece. The breathing tube will still be in place. At this point, the patient is off the vent and no longer being assisted but will have needed oxygen if they do initiate a breath.
4. Watch the patient for breathing. If any attempt is made to breathe, it is inconsistent with brain death and the test is stopped and the patient is placed back on the ventilator.
5. If the patient has any cardiac arrhythmias, low blood pressure or oxygen level that falls to less than 80% (normal level is 90-100%) then the test is discontinued. These finding will lead more to a conclusion that brain death has occurred.
6. If the carbon dioxide level increases above 60 (normal level is 35-45)—the apnea test is consistent with brain death. The brain is very sensitive to rising levels of carbon dioxide and the absence of a response is consistent with brain death.
Next post, we’ll talk about brain perfusion studies.
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