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Originally posted by new_here
Oh my dear sister Linda, I love you so much and I hope you didn't suffer. I told them you squeezed my hand- just a little. Barely noticeable. They said something about involuntary reflex or something. I said (or did I just scream it in my head?) if there's involuntary reflex, then there's signal, then there's brain activity!
It was not my decision to take you off life support, but that is no excuse for not fighting for you. You squeezed MY hand (I think) and so you called out to ME to help you. God help me, I let your husband and the "experts" decide to pull the plug.
Did your heart-rate not fluctuate for a couple of minutes? Is that not a sign of signals attempting to keep it going? If no signals from the brain, would it not just stop immediately?
I am so sorry they did not have to take me out kicking and screaming and restrain me. I am so sorry I did not fight for you. Ten years out, yet it still plagues me to this day.
OP: You are not responsible for my feelings by bringing up this topic. Thank you for giving my grief a voice.
edit on 9/18/2012 by new_here because: (no reason given)
Originally posted by justsaying
I am an extern in a cardiac critical care ICU. Most of our patients are in a fine line somewhere between life and death. Any time a patient is deteriorating and all the measures to save their life are not working, it is time to talk to the family about discontinuing life support and letting nature take its course. Most families don't want their loved ones to suffer any more than they already have, although there are those that believe than any and all means to sustain their loved ones is the only choice and keep them on ventilators and every heart drug imaginable. Eventually those drugs wont work anymore to sustain the heart, and because the body is going through multiple organ failure, they will eventually become severely septic. What quality of life is it for anyone to have if they have a signal going to their cerebrum and they can momentarily respond to a stimulus but they have massive infection and they can't pump blood anymore and the kidneys can't excrete urine and they are in severe pain? None. It is usually the nurse that is watching the patient and supporting the family at the end, and I have yet to see a doctor involved in this situation if they are a DNR. Furthermore, hospital policy forbids anyone working for the hospital to say a word about organ donation until after the patient has passed, and respectfully will abide by the significant other's wishes. So although someone is making a case for this being a big conspiracy, I am witnessing this first hand and I can honestly tell you it's not happened in our hospital.
Originally posted by severdsoul
True money is a factor, it speeds the process up a little, but in the end your MELD score is what determines if you get a transplant or not.
he legal definition of brain death may vary between different institutions and states [11,28]. At the Hospital of the University of Pennsylvania, brain death confirmation is basically defined by the three protocols mentioned previously.
The third method, that of using a cerebral blood flow scan (a technique which was previously ordered rather infrequently at our institution) in conjunction with only one brain death examination, dramatically shortens brain death stay. Therefore, we are currently using this method in order to minimize brain death stay and maximize organ procurement possibilities; nuclear medicine scans can be performed quite expeditiously at our institution. In most cases, the criteria for brain death determination by nuclear scan are clear cut, allowing a decision to be made without equivocation.
The brain scan technique, as previously described, is noninvasive, usually requiring only a venous access line to adminster the radio tracer . There are no known side-effects of such preparations and therefore organs of interest for transplantation, such as the kidney, liver, heart, lungs and pancreas, are not affected by performing this type of examination. The results of the scan are available within 30 min of radio tracer injection and the technique can be performed at the bedside with portable nuclear medicine cameras, although these are currently unavailable at our institution .
While cerebral arteriography can be used for the same purposes, it is generally more costly and time consuming than the nuclear scan [30,32]. Overall, the nuclear scan leads to a decrease in associated charges and is safe, fast and accurate . It has become the method of choice to determine brain death in our trauma population.