Anaesthesia & ICU
Brainstem Death Testing
AOMRC 2008 — preconditions, exclusion of confounders, 6 cranial nerve tests + apnoea test, 2 sets, 2 doctors.
Source: AOMRC 2008; FICM 2024
Step 1 of ~3
info
Preconditions
Patient: in coma + apnoea on ventilator; cause known + irreversible; coma ≥6h (≥24h if hypoxic-ischaemic injury).
Exclude confounders:
• Hypothermia (core ≥34°C).
• Severe biochemical / metabolic / endocrine disturbance.
• Reversible CNS depressants (sedatives, analgesics, paralytics — TOF monitor).
• Severe acid-base / electrolyte derangement.
• MAP ≥60 mmHg.
• Normal blood gases (PaCO₂ 4.5–6 kPa).
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Tetracosactide · Synthetic ACTH (short Synacthen test)
- Urea (13C) · 13C-urea breath test
- Tuberculin purified protein derivative · Mycobacterial antigen for delayed-type hypersensitivity testing
- Bupivacaine (Orthopaedic Nerve Blocks) · Local Anaesthetic — Long-acting Amide
- Ropivacaine (Orthopaedic Nerve Blocks) · Local Anaesthetic — Long-acting Amide (S-enantiomer)
- Caffeine Citrate · Methylxanthine (Apnoea of Prematurity)
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Anaphylaxis Under Anaesthesia · AAGBI 2018; NAP6
- Malignant Hyperthermia · AAGBI 2011; MHAUS
- Local Anaesthetic Systemic Toxicity (LAST) · AAGBI 2010; ASRA 2017
- Spinal Anaesthesia Hypotension Management · AAGBI; ASA
- Postoperative Nausea & Vomiting · Society for Ambulatory Anesthesia 2020; AAGBI
Decision support only. Always apply local guidelines and clinical judgement.