Brain Stem Death
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Brain Stem Death
Brainstem death is a clinical syndrome defined by the absence of reflexes with pathways through the brainstem – the "stalk" of the brain, which connects the spinal cord to the mid-brain, cerebellum and cerebral hemispheres – in a deeply comatose, ventilator-dependent patient. Identification of this state carries a very grave prognosis for survival; cessation of heartbeat often occurs within a few days, although it may continue for weeks if intensive support is maintained.A Code of Practice for the Diagnosis and Confirmation of Death. Academy of Medical Royal Colleges, London, 2008 In the United Kingdom, death can be certified on the basis of a formal diagnosis of brainstem death, so long as this is done in accordance with a procedure established in "A Code of Practice for the Diagnosis and Confirmation of Death", published in 2008 by the Academy of Medical Royal Colleges. The premise of this is that a person is dead when consciousness and the ability to breathe are ...
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Brainstem
The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is continuous with the thalamus of the diencephalon through the tentorial notch, and sometimes the diencephalon is included in the brainstem. The brainstem is very small, making up around only 2.6 percent of the brain's total weight. It has the critical roles of regulating cardiac, and respiratory function, helping to control heart rate and breathing rate. It also provides the main motor and sensory nerve supply to the face and neck via the cranial nerves. Ten pairs of cranial nerves come from the brainstem. Other roles include the regulation of the central nervous system and the body's sleep cycle. It is also of prime importance in the conveyance of motor and sensory pathways from the rest of the brain to the body, and from the body back to t ...
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Mechanical Ventilation
Mechanical ventilation, assisted ventilation or intermittent mandatory ventilation (IMV), is the medical term for using a machine called a ventilator to fully or partially provide artificial ventilation. Mechanical ventilation helps move air into and out of the lungs, with the main goal of helping the delivery of oxygen and removal of carbon dioxide. Mechanical ventilation is used for many reasons, including to protect the airway due to mechanical or neurologic cause, to ensure adequate oxygenation, or to remove excess carbon dioxide from the lungs. Various healthcare providers are involved with the use of mechanical ventilation and people who require ventilators are typically monitored in an intensive care unit. Mechanical ventilation is termed invasive if it involves an instrument to create an airway that is placed inside the trachea. This is done through an endotracheal tube or nasotracheal tube. For non-invasive ventilation in people who are conscious, face or nasal mask ...
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Hypothermia
Hypothermia is defined as a body core temperature below in humans. Symptoms depend on the temperature. In mild hypothermia, there is shivering and mental confusion. In moderate hypothermia, shivering stops and confusion increases. In severe hypothermia, there may be hallucinations and paradoxical undressing, in which a person removes their clothing, as well as an increased risk of the heart stopping. Hypothermia has two main types of causes. It classically occurs from exposure to cold weather and cold water immersion. It may also occur from any condition that decreases heat production or increases heat loss. Commonly, this includes alcohol intoxication but may also include low blood sugar, anorexia and advanced age. Body temperature is usually maintained near a constant level of through thermoregulation. Efforts to increase body temperature involve shivering, increased voluntary activity, and putting on warmer clothing. Hypothermia may be diagnosed based on either a person ...
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Depressant
A depressant, or central depressant, is a drug that lowers neurotransmission levels, which is to depress or reduce arousal or stimulation, in various areas of the brain. Depressants are also colloquially referred to as downers as they lower the level of arousal when taken. Stimulants or "uppers" increase mental or physical function, hence the opposite drug class of depressants is stimulants, not antidepressants. Depressants are widely used throughout the world as prescription medicines and as illicit substances. Alcohol is a very prominent depressant. Alcohol can be and is more likely to be a large problem among teenagers and young adults. When depressants are used, effects often include ataxia, anxiolysis, pain relief, sedation or somnolence, and cognitive or memory impairment, as well as in some instances, euphoria, dissociation, muscle relaxation, lowered blood pressure or heart rate, respiratory depression, and anticonvulsant effects. Depressants also act to produce anes ...
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Artificial Ventilation
Artificial ventilation (also called artificial respiration) is a means of assisting or stimulating respiration, a metabolic process referring to the overall exchange of gases in the body by pulmonary ventilation, external respiration, and internal respiration. It may take the form of manually providing air for a person who is not breathing or is not making sufficient respiratory effort, or it may be mechanical ventilation involving the use of a mechanical ventilator to move air in and out of the lungs when an individual is unable to breathe on their own, for example during surgery with general anesthesia or when an individual is in a coma or trauma. Types Manual methods Pulmonary ventilation (and hence external parts of respiration) is achieved through manual insufflation of the lungs either by the rescuer blowing into the patient's lungs (mouth-to-mouth resuscitation), or by using a mechanical device to do so. This method of insufflation has been proved more effective than meth ...
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British Medical Journal
''The BMJ'' is a weekly peer-reviewed medical trade journal, published by the trade union the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world's oldest general medical journals. Originally called the ''British Medical Journal'', the title was officially shortened to ''BMJ'' in 1988, and then changed to ''The BMJ'' in 2014. The journal is published by BMJ Publishing Group Ltd, a subsidiary of the British Medical Association (BMA). The editor-in-chief of ''The BMJ'' is Kamran Abbasi, who was appointed in January 2022. History The journal began publishing on 3 October 1840 as the ''Provincial Medical and Surgical Journal'' and quickly attracted the attention of physicians around the world through its publication of high-impact original research articles and unique case reports. The ''BMJ''s first editors were P. Hennis Green, lecturer on the diseases of children at the Hunterian School of Medicine, who also was its f ...
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Chris Pallis
Christopher Agamemnon Pallis (2 December 1923, in Bombay – 10 March 2005, in London) was an Anglo-Greek neurologist and libertarian socialist intellectual. Under the pen-names Martin Grainger and Maurice Brinton, he wrote and translated for the British group Solidarity from 1960 until the early 1980s. As a neurologist, he produced the accepted criteria for brainstem death, and wrote the entry on death for ''Encyclopædia Britannica''. Life Chris Pallis was born to a prominent Anglo-Greek family, "of whose intellectual achievements he was always extremely proud". The poet Alexandros Pallis was a great-uncle, and so the writers Marietta Pallis and Marco Pallis were also relatives. His father Alex was general manager of the family firm of merchant bankers, Ralli Brothers; when he retired, he returned from India to settle in Switzerland. Educated there, Chris Pallis became fluent in French, English and Greek. In 1940 the family managed to take the last boat out of France, and set ...
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London
London is the capital and largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary down to the North Sea, and has been a major settlement for two millennia. The City of London, its ancient core and financial centre, was founded by the Romans as '' Londinium'' and retains its medieval boundaries.See also: Independent city § National capitals The City of Westminster, to the west of the City of London, has for centuries hosted the national government and parliament. Since the 19th century, the name "London" has also referred to the metropolis around this core, historically split between the counties of Middlesex, Essex, Surrey, Kent, and Hertfordshire, which largely comprises Greater London, governed by the Greater London Authority.The Greater London Authority consists of the Mayor of London and the London Assembly. The London Mayor is distinguished fr ...
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Royal College Of Physicians
The Royal College of Physicians (RCP) is a British professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination. Founded by royal charter from King Henry VIII in 1518, the RCP is the oldest medical college in England. It set the first international standard in the classification of diseases, and its library contains medical texts of great historical interest. The college is sometimes referred to as the Royal College of Physicians of London to differentiate it from other similarly named bodies. The RCP drives improvements in health and healthcare through advocacy, education and research. Its 40,000 members work in hospitals and communities across over 30 medical specialties with around a fifth based in over 80 countries worldwide. The college hosts six training faculties: the Faculty of Forensic and Legal Medicine, the Faculty for Pharmaceutical Medicine, the Faculty of Occupational Medicine the Fac ...
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Organ Transplantation
Organ transplantation is a medical procedure in which an organ (anatomy), organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a Organ donation, donor site to another location. Organ (anatomy), Organs and/or Tissue (biology), tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source. Organs that have been successfully transplanted include the Heart transplantation, heart, Kidney transplantation, kidneys, Liver transplantation, liver, Lung transplantation, lungs, Pancreas transplantation, pancreas, Intestinal transplant, intestine, Thymus transplantation, thymus and uterus transplantation, uterus. Tissues include Bone grafting, bones, tendons (both referr ...
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Death Certificate
A death certificate is either a legal document issued by a medical practitioner which states when a person died, or a document issued by a government civil registration office, that declares the date, location and cause of a person's death, as entered in an official register of deaths. An official death certificate is usually required to be provided when applying for probate or administration of a deceased estate. They are also sought for genealogical research. The government registration office would usually be required to provide details of deaths, without production of a death certificate, to enable government agencies to update their records, such as electoral registers, government benefits paid, passport records, transfer the inheritance, etc. Nature of a certificate Before issuing a death certificate, the authorities usually require a certificate from a physician or coroner to validate the cause of death and the identity of the deceased. In cases where it is not comple ...
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Emotional Trauma
Psychological trauma, mental trauma or psychotrauma is an emotional response to a distressing event or series of events, such as accidents, rape, or natural disasters. Reactions such as psychological shock and psychological denial are typical. Longer-term reactions include unpredictable emotions, flashbacks, difficulties with interpersonal relationships and sometimes physical symptoms including headaches or nausea. Trauma is not the same as mental distress or suffering, both of which are universal human experiences. Given that subjective experiences differ between individuals, people will react to similar events differently. In other words, not all people who experience a potentially traumatic event will actually become psychologically traumatized (although they may be distressed and experience suffering). Some people will develop post-traumatic stress disorder (PTSD) after being exposed to a major traumatic event (or series of events). This discrepancy in risk rate can be ...
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