Procedure for turning off life support?

Question

My brother died in ICU (England) last week, and nobody was contacted. Not me, or even his doctor who is a family friend. I thought they would need to let someone know before turning it off?

More info. He died of a heart attack (38years old), and drugs were involved. He was in ICU for less than 24 hours.

Apparently he was brain dead. He was revived, placed on life support, they did tests, decided he was brain dead, and switched him off. I'm just annoyed that they didn't contact anyone. They said they had no next of kin details, however, he had his phone on him, and I had been redialling it for hours. The name on the phone was "Sis". Also, his doctor would have been on his records. She would have called me. I do not want to prosecute, I just am having a hard time dealing with this and my doctor told me they switched the life support off too early. But nothing will bring him back now I suppose. In the movies they call the family, I just thought they would have kept him on a little longer while they found out who his family was.

Answer 1

My deepest condolence to you.

You have every right to get mad. Determining brain dead takes some procedural process or protocol . He shoudln't have been taken off the ventilator without the presence of kinfolk. In a case, like this, the doctors usually include the family in the decision. Was he an organ donor? Maybe, that was the main reason. They wanted to harvest some vital organs; once the paient is pronounced brain-dead.


This incidence couldn't happen here in the US. Somebody has to answer for this atrocity and complete disregard for a person's dignity.


What diagnosis did they come up with? Heart attack or OD from drugs. These diagnoses are reversible. How long was he in the hospital? How long was he in a coma?

If left on the ventilatory support, he would have lived much longer.


A diagnosis of brain dead is arrived after a physical exam. The exams must show complete absence of brainstem functions, and may include two isoelectric (flat-line) EEGs taken 24 hours apart

Two flat ( isoelectric) EEG's that showed no electrical brain activity taken 24 hrs apart. is the confirmatory exam. There's also a test to take him off the machine and see if he can sustain life without it.

In simple terms, brain death is the irreversible end of all brain activity.

BRAIN DEATH


1. State laws vary, but a patient is generally considered expired when there is no brain stem function.



2. Brain death cannot be declared if the patient is hypothermic (T < 32.2°C). If they are intoxicated or have ingested a substance, they cannot be declared dead until 4-5 half lives of the suspected substance have passed. Note that substances we give patients such as paralytics, benzos, sedatives, etc. also fall under this category.



3. General criteria: at least 24 hours must pass between consecutive examinations. Patient should have fixed pupils without eye movements, and should not have any of the following reflexes: corneals, gag, oculocephalic, oculovesibular (cold calorics), or overbreathing the ventilator.



4. Confirmatory tests can be helpful and are required by law in some states. They include any of the following:

· An isoelectric EEG for 30 minutes with the machine set at high gain.

· No cerebral blood flow as determined by radionucleotide angiography.

· A “positive” apnea test (generally has less false positive results and is therefore used most often clinically).



5. Do not forget that these patients are ideal candidates for organ donation, and consult the family and your local donor network accordingly.


You should consider taking legal action. Demand autopsy to determine the real cause of death.


There's a law here in the States; for any death that occur within 24 hrs of hosp admission. It's considered a coroner's case; autopsy is done even without the family member's consent. They want to rule out foul play including criminal negligence on the part of the hospital.

Answer 2

Turning Off Life Support

Answer 3

Did he die because they turned off the life support, he did he just die?
I work in an AUS ICU, and some patients will still die even though we are doing everything we possibly can. 24 hours is a long time to try to keep someone alive.
Often patients who have had heart attacks have cardiac surgery (like a valve replacement, etc) which usually happen very fast if they are needed. But just because we fix some part of their heart doesn't mean it won't pack it in anyway.
If your brother went into asystole (his heart completely stops, there are no electrical impulses passing through it at all) then there is very little we can do to bring them back. The only time a defibrillator shock can bring someone back is when there are electrical impulses running through the heart still. (ie. Ventricular tachycardia or ventricular fibrillation).
I'm sure that they wouldn't have just turned off the life support. There are certain things they have to evaluate before they can do it.
If your brother was unable to come off the life support, usually because the heart attack caused a lack of blood, nutrients and oxygen to the brain and he was now brain dead, there is no point in keeping him on the life support because they are the only things keeping him alive.
I'm very sorry for your loss, and if you do really believe that they did the wrong thing, then get yourself a lawyer and you will be able to prosecute the doctors, nurses, other health care professionals and the hospital. and you'll probably get a large cash settlement out of it too.

Answer 4

First of all
I am very sorry for your loss --- I know that this is not an easy thing at all !
And, I really don't know what the regulations for such matters are in the UK --- but, in the states -- the people in the hospital have certain criteria and guidelines that they adhere to and have certain leverages in play that allows them some major room in which to decide on such things ---- BUT --- in any case -- there should have been calls made to inform people so that they could make Personal decisions within this event that should be considered AS important !! It is an Ethics thing if nothing else ! And, it shows a complete lack of a caring attitude with Someone -- whoever the "decision maker" was here !!
Maybe someone with a lot more knowledge and leverage in such stuff will come along here with some major input for you -- just know in the meantime that there are those that will be thinking of you in all of this --- and praying that comfort will not be far away !!

Answer 5

Find a lawyer. They are not allowed to turn life support off without the full agreement of family members.

Answer 6

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