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Intensive care nurses have doubts about method for establishing brain death
Date:6/28/2011

More than half of Sweden's intensive care nurses doubt that a clinical neurological examination can establish that a patient is brain dead. Intensive care nurses also perceive that this uncertainty can affect relatives when the question of organ donation is raised, is reveiled in a thesis from the Sahlgrenska Academy, University of Gothenburg, Sweden.

End-of-life care in an intensive care unit (ICU) also includes caring for patients who are brain dead and who by their death become potential organ donors. The thesis investigated attitudes and actions of ICU nurses in the context of organ donation. Information was gathered through both interviews and a questionnaires that went out to 1,100 ICU nurses in Sweden - around half of the total workforce.

The survey showed that less than half 48 per cent of ICU nurses perceive that solely clinical neurological examinations can be relied upon for determining that a patient is brain dead. Swedish regulations stipulate that physicians should perform certain clinical tests to establish that the person is deceased. Supplementary contrast x-ray of the brain is only performed in some circumstances, for example when the patient has been affected by medication.

The author of the thesis, Anne Flodn, a registered nurse and researcher at the Institute of Health and Care Sciences, is of the opinion that it is problematic if the nurses' caring for these patients experience doubts about the reliability of the methods used to establish death. She believes that one explanation for their doubts could be that the concept of brain death challenges most of our preconceptions about death and dying. The deceased patient still has a heartbeat and the body is warm, but is, according to Swedish legislation, deceased.

"If you don't perceive the patient as deceased it's not surprising that you don't see the possibility for organ donation."

Respecting the wishes of the deceased patient was viewed as v
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Contact: Anne Flodn
anne.floden@vgregion.se
46-070-646-1267
University of Gothenburg
Source:Eurekalert

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