Is the patient brain dead?

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AN INTERESTING CASE

A 30 year old female was found unconscious  with weak pulse and apnea (Respiratory rate=0). The paramedics completed the Airway, Breathing & Circulation (ABC). Naloxone, glucose and thiamine levels are normal. Head CT scan shows no hemorrhage or ischemia. The EEG shows flat lines.

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The answer is NO; the patient is not brain dead. We will order a drug screen. The patient was having phenobarbital poisoning which can present as a brain dead patient! Whilst actually its not!

TREATMENT

The patient may receive:

  • Activated charcoal
  • Gastric lavage
  • Laxative

PROGNOSIS

The prognosis (probable outcome) depends on the symptoms observed by the health care provider.

  • Mild — The patient can be aroused. No further treatment will probably be necessary, but the patient will be monitored in the hospital.
  • Moderate — Breathing and other vital signs are normal, but the patient cannot be aroused. Recovery will probably occur within 24 – 48 hours with proper care.
  • Severe — Breathing and other vital signs may be abnormal and the patient cannot be aroused. Recovery will probably occur within 3 – 5 days, depending on the amount swallowed.

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Burhan Ahmed, is currently the Editor-in-Chief at Medicalopedia.org. He completed his residency from Michigan State University in 2015. He has written three short revision books on Biology, Stomatology and Gynecology, has 4 publications to his name. He is pursuing career in cosmetic dermatology.