Death by Neurological Criteria Checklist

MTN has recently updated its Death by Neurologic Criteria (Brain Death) Checklist. This update is to ensure the checklist is aligned with current pronouncement guidelines as issued by the American Academy of Neurology (AAN), Child Neurology Society (CNS), and Society of Critical Care Medicine (SCCM). This checklist is for assessing adult patients only. We will adopt the pediatric checklist developed by Children’s Mercy Hospital once it becomes available. Hospitals are invited to adopt and/ or use this document as they feel appropriate. The updates are summarized below.

Updates to the MTN Death By Neurologic Criteria Checklist:

• At the recommendation of the AAN/ CNS/SCCM and the Center for Practical Bioethics MTN will be shifting terminology to Death by Neurologic Criteria (DNC) rather than brain death.

• Section I. Patient is unresponsive with known cause and 24-hour period of observation required for anoxic injuries.

• Section II. Patient has a temperature of 36° C/96.8° F for at least 24 hours prior to testing.

• Section III. Notes that neurologic examination is required to declare death by neurologic criteria (reverse side provides detailed exam guidelines)

• Ancillary Test Section: Ancillary tests are optional. EEG is no longer acceptable. Acceptable ancillary tests include cerebral angiography, cerebral scintigraphy (CBF) and transcranial doppler (TCD).

Please remember that an update to MTN is required any time a patient is presenting without brainstem reflexes or there is a plan for Death by Neurologic Criteria testing.

An electronic copy of the updated MTN checklist and/or the AAN/CNS/SCCM article reviewing the guideline updates can be provided by your HSC upon request.