Brain death is not the same as coma, because someone in a coma is unconscious but still alive. Brain death occurs when a critically ill patient dies sometime after being placed on life support. This situation can occur after, for example, a heart attack or stroke.
One is when the heart and lungs have stopped working. The other is when the entire brain has stopped working. The second is known as brain death. A patient cannot recover from brain death.
But without brain function, the body eventually shuts down, unless there is medical intervention. Someone on a ventilator may appear to be breathing, but cannot breathe on their own. While the heart usually stops within 72 hours, it could continue beating for “a week or so,” Varelas said.
The brain stem also relays information to and from the brain to the rest of the body, so it plays an important role in the brain's core functions, such as consciousness, awareness and movement. After brain death, it's not possible for someone to remain conscious.
It is the complete stopping of all brain function and cannot be reversed. It means that, because of extreme and serious trauma or injury to the brain, the body's blood supply to the brain is blocked, and the brain dies. Brain death is death. It is permanent.
Patients may be misdiagnosed as “brain dead” if their doctors fail to order the necessary tests to determine whether or not they are aware of their condition and unable to communicate. Individuals who have suffered severe brain injuries need to be accurately diagnosed to receive the best possible care and treatment.
Can someone hear while on life support? It's hard to say for sure whether people on life support can hear their loved ones and healthcare providers. Small studies suggest it's possible. This probably depends on the level of sedation and how severe any possible brain injury is.
Brain Death Testing
These tests would confirm: the patient has no response to verbal or visual command, the patient is flaccid; pupils are unreactive and fixed; has no oculocephalic, gag, oculovestibular or corneal reflexes; and there is no spontaneous respiration.
The first organ system to “close down” is the digestive system. Digestion is a lot of work! In the last few weeks, there is really no need to process food to build new cells. That energy needs to go elsewhere.
Generally, most patients at a hospital do come out of a coma. Typically, a coma does not last more than a few days or couple of weeks.
Earlier this year, 13-year-old Trenton McKinley from Alabama and his parents hit the media circuit to talk about the miracle of Trenton awakening after being declared brain dead from a vehicle accident—1 day before his organs were scheduled to be harvested.
Brain death is defined as the irreversible loss of all functions of the brain, including the brainstem. The three essential findings in brain death are coma, absence of brainstem reflexes, and apnoea.
A variety of reflex movements have been reported in patients with brain death, such as plantar responses, muscle stretch reflexes, abdominal reflexes, and finger jerks (2). Because the aforementioned reflexes are spinal reflexes, the existence of such reflex movements does not preclude the diagnosis of brain death.
Individuals may even occasionally grimace, cry, or laugh. A coma rarely lasts beyond two to four weeks.
The organs are no longer able to function on their own. Keeping the treatment going at that point may draw out the process of dying and may also be costly. Choosing to remove life support usually means that the person will die within hours or days. The timing depends on what treatment is stopped.
Contrary to previous notions that brain cells die within 5 to 10 minutes, evidence now suggests that if left alone, the cells of the brain die slowly over a period of many hours, even days after the heart stops and a person dies.
They Know They're Dying
Dying is a natural process that the body has to work at. Just as a woman in labor knows a baby is coming, a dying person may instinctively know death is near. Even if your loved one doesn't discuss their death, they most likely know it is coming.
This stage is also one of reflection. The dying person often thinks back over their life and revisits old memories.4 They might also be going over the things they regret.
Even when vascular collapse is the primary event, brain and lung functions stops next. The heart is the last organ to fail.
Brain death, by contrast, is final. Medical technology can keep brain-dead individuals on life support. At the same time, those in a persistent vegetative state (or "chronic wakefulness without awareness") may die naturally if this is in their living will.
People in a vegetative state can open their eyes, but they cannot speak or do things that require thought or conscious intention, and they have no awareness of themselves or their environment.
Such patients are never come back to normal life. They are considered living or non-living. The patient in brain-dead ad has no self-consciousness.
The important findings, along with observations of long-time palliative care doctors and nurses, show: Brain activity supports that a dying patient most likely can hear. Even if awareness of sound cannot be communicated due to loss of motor responses, the value of verbal interactions is measurable and positive.
Patients are unable to vocalize during mechanical ventilation due to the breathing tube.