Brain dead and bleeding

[Dean Lutrin]

Brain dead is a clinical diagnosis - that is what I am referring to. The
case I referred to is the one that got me thinking about the question

Dean

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of nappio at aol.com
Sent: Thursday, December 21, 2006 7:29 PM
To: trauma-list at trauma.org
Subject: Re: Brain dead and bleeding

Your not brain dead until your brain dead.  The last I heard you can't prove
this with a head CT.  Certainly, depending on a locations resources in
specific parts of the world triaging such a case to expectant management is
acceptable, however, in the modern world if the resources are there,
pursuing definitive surgery seems academic, unless pt/family wishes decide
otherwise. DN 
 
 
-----Original Message-----
From: deanlutrin at gmail.com
To: trauma-list at trauma.org
Sent: Thu, 21 Dec 2006 12:11 PM
Subject: Brain dead and bleeding


Dear list

A quick question. What are your feelings on operating on a patient who comes
into your ER brain dead with intraabdominal bleeding? Do you treat the
abdomen on its own merits assuming that some of the low GCS may be
attributable to hypovolaemia etc...

I am of course assuming that the patient has been intubated without drugs,
there is no drug history etc etc...

We debated this a bit today where one of the surgeons did not operate on a
case because the CT brain showed unsurvivable injuries and was roundly
criticised.

Is this a matter of opinion or are there good answers?

Thanks 

Dean Lutrin
JHB, SA

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