Brain dead and bleeding

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The debate has already gone far, but to begin with- can anyone explain the 
case to me, cuz I don't seem to understand.

Dean- you are talking about a patient who "comes
into your ER brain dead". Well, if the pateint is brain dead then it's a 
cadavar, not a pateint. If he is brain dead, then restoring perfusion raise 
his GCS, will it?
But on the other hand, you can't say he IS brain dead if he's just rolled 
into your ER, unless the head is not attached to the neck and he is 
ventilated through a cricothyroidostomy or something (and bleeding). As far 
as I know, brain death is not a diagnosis made by paramedics in the field, 
not to mention that the pateint still had a pulse (if he was bleeding)- 
meaning that as far as the medics were concered, he was still alive (which a 
brain dead person is NOT).

I'd like to know what ment your original definiton of "brain dead" and what 
the CT showed
>From: "Dean Lutrin" <deanlutrin at gmail.com>
>Reply-To: "Trauma &amp; Critical Care mailing list" 
><trauma-list at trauma.org>
>To: "'Trauma & Critical Care mailing list'" <trauma-list at trauma.org>
>Subject: Brain dead  and bleeding
>Date: Thu, 21 Dec 2006 19:11:48 +0200
>
>Dear list
>
>A quick question. What are your feelings on operating on a patient who 
>comes
>into your ER brain dead with intraabdominal bleeding? Do you treat the
>abdomen on its own merits assuming that some of the low GCS may be
>attributable to hypovolaemia etc...
>
>I am of course assuming that the patient has been intubated without drugs,
>there is no drug history etc etc...
>
>We debated this a bit today where one of the surgeons did not operate on a
>case because the CT brain showed unsurvivable injuries and was roundly
>criticised.
>
>Is this a matter of opinion or are there good answers?
>
>Thanks
>
>Dean Lutrin
>JHB, SA
>
>--
>trauma-list : TRAUMA.ORG
>To change your settings or unsubscribe visit:
>http://www.trauma.org/traumalist.html

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