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Abstract Details

Variability In Reported Physician Practices For Brain Death Determination
Neuro Trauma, Critical Care, and Sports Neurology
P5 - Poster Session 5 (5:30 PM-6:30 PM)
4-042

Determine the frequency of training, self-perceived competence and the examination performed among physicians who complete brain death examinations in practice.
The degree of training and variability in the clinical brain death examination performed by physicians is not known.
Surveys were distributed to physicians (including physicians-in-training) practicing at three separate academic medical centers. Data, including level of practice, training received in completion of a brain death examination, examination components performed and use of confirmatory tests were collected. Data were evaluated for accuracy in the brain death examination, self-perceived competence in the examination and indications for confirmatory tests.
Of 225 total respondents, 68 reported completing brain death examinations in practice.  Most physicians who complete a brain death examination reported they had received training in how to complete the examination (76.1%). Seventeen (25%) respondents reported doing a brain death examination that is consistent with the current practice guideline. 10.3% of physicians did not report completing an apnea test as a part of their brain death assessment. Of clinicians who obtain confirmatory tests on an as-needed basis, 28.3% do so if a patient breathes during an apnea test, a clinical finding that is not consistent with brain death.

There is substantial variability in how physicians approach the adult brain death examination, but our survey also identified lack of training in nearly 1 in 4 academic physicians.  A formal training course in the principles and proper technique of the brain death examination by physicians with expert knowledge of this clinical assessment is recommended.
Authors/Disclosures
Sherri A. Braksick, MD, FAAN (Mayo Clinic)
PRESENTER 		Dr. Braksick has nothing to disclose.
Christopher P. Robinson, DO (University of Florida Department of Neurology) Dr. Robinson has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for law firms.
Gary S. Gronseth, MD, FAAN (University of Kansas) Dr. Gronseth has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Brain & Life. Dr. Gronseth has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology. Dr. Gronseth has received personal compensation in the range of $0-$499 for serving as a Member/EBM consultant Guideline Development Subcommittee with AAN.
Sara E. Hocker, MD, FAAN (Saint Luke's Hospital) The institution of Dr. Hocker has received research support from Yale University. Dr. Hocker has received publishing royalties from a publication relating to health care.
Eelco F. Wijdicks, MD, FAAN (Mayo Clinic W8) Dr. Wijdicks has received publishing royalties from a publication relating to health care.
Alejandro A. Rabinstein, MD, FAAN (Mayo Clinic) Dr. Rabinstein has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Boston Scientific. Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Shionogi . Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Chiesi. Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ceribell. Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurocritical care/NCS-Springer. Dr. Rabinstein has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wolters/UptoDate. Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for EBSCO/DynaMed. Dr. Rabinstein has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AHA. Dr. Rabinstein has received publishing royalties from a publication relating to health care. Dr. Rabinstein has received publishing royalties from a publication relating to health care. Dr. Rabinstein has received publishing royalties from a publication relating to health care. Dr. Rabinstein has received publishing royalties from a publication relating to health care.