Brain death is a condition where the brain and brain stem have ceased functioning. It can occur after many types of brain trauma and medical conditions. The important thing to remember is that brain death is an irreversible condition. Once a person progresses to brain death, they have died.  It is important to always make this distinction when speaking with family members regarding brain death. It is not a 'coma' (in the colloquial sense of the term.) People do not 'wake up' from brain death. There should never be 'goals of care' discussions for a patient who is brain dead. 

​

Once a patient reaches brain death, there is a protocol for documenting the diagnosis prior to the formal death declaration. This process in outlined in the AHS Brain Death Policy. This policy as well as other important AHS policies and procedures, can be found on AHS Policy Tech, which can be found under the 'web apps' tab on the AHS Intranet page. 

​

When the care team initiates the brain death protocol, the order set for physiologic support during brain death (Gift of Life order set) should be concomitantly started. Although we begin organ support for possible donation at time of initial brain death documentation, we as a care team NEVER discuss organ donation with any family. Donor Network West, our regional organ procurement agency are the ONLY persons who should bring up organ donation with any family. If a family brings up the potential for donation with you in conversation, please tell the family member that there are support teams separate from the care team who you can connect them with to answer any questions regarding organ donation. The number for donor network west is usually posted in the ICU. If you cannot find it, ask the charge nurse to help you reach the DNW representative on duty.