Kerala becomes first state to issue brain death certification guidelines
Kerala has become the first state in India to adopt a standard operating procedure (SOP) for determining brain death cases, under which all hospitals - private and government - will have to follow the SOP guidelines for organ donation from the deceased. The SOP was formulated amid growing public concern over the possibility of manipulation or coercion to make organs available for transplant.
What the SOP guidelines require hospitals to do
According to the SOP guidelines a team of four doctors including at least one government doctor will be authorized to declare a patient brain dead. All four are required to sign the brain death certificate unanimously. The primary condition for declaring a patient brain dead under the SOP guidelines is that they should be 100% out of reversible causes of coma.
Drug-induced comas not under ambit of brain dead
The use of intoxicants, neuro-mascular relaxants, depressant drugs, hypothermia or some endocrine disorders may induce coma which may be reversible, and thus these do not come under the ambit of brain dead, detailed the SOP guidelines.
What tests are required to declare brain death
To determine brain death, the appointed medical team is required to perform the Apnea test twice with an interval of six hours to check for definitive signs of loss of brainstem function. The test results will show if the patient can ever breathe by himself/herself in the future. A second round of Apnea tests are required before brain death is declared.
