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The recommendations have widespread international society endorsement and can serve to guide professional societies and countries in the revision or development of protocols and procedures for determination of brain death/death by neurologic criteria, leading to greater consistency within and between countries.
The lowest possible PGCS (the sum) is 3 (deep coma or death) whilst the highest is 15 (fully awake and aware person). The pediatric GCS is commonly used in emergency medical services. In patients who are intubated, unconscious, or preverbal, the motor response is considered the most important component of the scale.
The phenomenon has been observed to occur several minutes after the removal of medical ventilators used to pump air in and out of brain-dead patients. [4] It also occurs during testing for apnea—that is, suspension of external breathing and motion of the lung muscles—which is one of the criteria for determining brain death used for example by the American Academy of Neurology.
Jahi McMath was a thirteen-year-old girl who was declared brain dead in California following surgery in 2013. This led to a bioethical debate engendered by her family's rejection of the medicolegal findings of death in the case, and their efforts to maintain her body using mechanical ventilation and other measures.
In 1995, the American Academy of Neurology (AAN) established the criteria that became the medical standard for diagnosing neurologic death. At that time, three clinical features had to be satisfied to determine "irreversible cessation" of the total brain, including coma with clear etiology, cessation of breathing, and lack of brainstem reflexes ...
The Uniform Determination of Death Act has been enacted in 37 states, the District of Columbia, and the U.S. Virgin Islands. Jurisdiction with enactment The Uniform Determination of Death Act (UDDA) is a model state law that was approved for the United States in 1981 by the National Conference of Commissioners on Uniform State Laws, in cooperation with the American Medical Association, the ...
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The American Academy of Neurology created a prerequisite and neurological clinical assessment to be used as guidelines for determining brain death published in 2010. [6] To be considered for brain death the body must have a determinant cause of coma, have normal systolic blood pressure, and pass two neurological tests.