Covenant physician explains brain death - KCBD NewsChannel 11 Lubbock

Covenant physician explains brain death

Pictured: Ryan Lewis, Covenant emergency medicine physician Pictured: Ryan Lewis, Covenant emergency medicine physician

It's difficult for Marlise Munoz's parents to see her now.

On Saturday, a Texas judge ordered that Munoz be taken off life support. According to court documents, she's been brain dead since November 28th.

But what does brain death really mean? Ryan Lewis, a Covenant emergency medicine physician, said that many people confuse it with being in a coma.

"Brain death is very different than a coma," Lewis said. "A coma is something that's a decreased level of consciousness, but while you're in a coma, you still have your body systems that are continuing to function. Brain death in legal terms requires many criteria to be met. There has to be certain exclusion criteria, and you have to have an absence of cerebral function and brain stem function."

A long-term coma can become a vegetative state. In a rare number of circumstances, patients have come out of that.

But, if diagnosed correctly, brain death is permanent.

"To be classified as brain dead there is a cessation of all life," Lewis sad. "It's irreversible. You have to look at brain stem function. The brain stem drives our most basic functions for keeping us alive, so the definition of brain death basically implies that the body is unable to use any systems that can keep us alive.

To test for brain death, doctors check for blood flow and electrical activity in the brain.

They perform tests such as shining a light in the eyes to see if the pupils move and constrict, and gently rubbing the eyeballs with a cotton ball to test for a reaction. Sometimes they put ice water into the ears and see if the eyes move in that direction.

"There are certain tests that we check for what's called apnea, or lack of respiration," Lewis said. "Certain basic reflexes - corneal reflexes - any type of cranial nerve function is looked at."

Doctors perform these tests multiple times over a 48 hour timeline to check for activity in the brainstem.

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