A 33-year-old cyclist is struck by a car in a head-on collision and arrives intubated to Emergency depament. Upon arrival, his Glasgow Coma Scale is 3. He has fixed and dilated pupils with absent gag reflex and with absence of spontaneous breathing effos. EEG shows isolated bursts along a flat line. What is the next step in management of this patient?
High-Yield Explanation
Brain stem death 1. Evaluate 2. Mid brain - light reflex 3. Pom - corneal reflex 4. Medulla - gag reflex Other option a. Do urgent craniotomy - not need for intra parenchymal hemorrhage b. Do urgent ventriculostomy - raised ICP hemorrhage c. Do urgent Burr hole surgery - EDH/ SDH with posturing