Does my relative feel pain?
Bereavement
No. When someone is dead they don’t feel
pain. Brain stem death is death.
Some families find that a lock of hair or a
handprint can be of some comfort in the
future. Ask your nurse if you would like this.
What happens next when brain
stem death has been diagnosed?
Leighton Hospital also offers a bereavement
service coordinated by the Bereavement
Manager, who will provide support and
information at this time.
You will have the time you need to stay with
your relative and say your goodbyes. If you
wish, it can be arranged for a member of the
hospital chaplaincy to be with you. The
doctor and nurse will talk to you about the
diagnosis and any decisions that you may
have to make.
Organ Donation
If you want to consider organ donation the
breathing tube will remain in situ and the
Specialist Nurse - Organ Donation will be
contacted for you to discuss this further. If
you do not want to consider organ donation,
your wishes will be respected and the
breathing tube will be removed when you
feel ready. Shortly after this your relative’s
heart will stop.
We realise that this is a difficult
time for you so please do not
hesitate to speak to the medical
and nursing staff about any
concerns you may have or if there
is anything that they can assist
you with.
Your nurse can provide further information
regarding this service, along with a
bereavement booklet. This may give you
some useful information to assist you in the
coming weeks.
Brain Stem Death
This leaflet is available in audio, Braille,
large print and other languages. To request
a copy, please speak to the Specialist Nurse
– Organ Donation.
This leaflet has been reviewed by the
Readers’ Panel October 2010.
A guide for
families and friends
Critical Care Unit
Leighton Hospital
Middlewich Road
Crewe
Cheshire
CW1 4QJ
Revised and reprinted March 2013
Ref: SC/CCS/0060313
Review March 2015
www.mcht.nhs.uk
Brain stem death is a difficult
concept to grasp and we
encourage you to speak to the
doctors and nurses about any
questions you may have. We
hope that this leaflet will help you
to understand some of the issues
surrounding brain stem death and
brain stem death tests.
What is brain stem death?
Brain stem tests
When the brain stem stops working, the
brain cannot send messages to the body to
control our functions and equally cannot
receive messages back from the body. If the
brain stem is dead then the person has no
chance of recovery and no treatment can
reverse this.
Tests will be carried out to see if your
relative:
• breathes without the ventilator
• responds to physical stimulation
• blinks when stimulated
• coughs or gags
• reacts to a cold stimulus
www.mcht.nhs.uk
The brain stem can stop working for many
• and whether their pupils react to light
reasons, usually when there is not enough
shone in their eyes
blood or oxygen reaching the cells in the
Patient Experience Team
brain. The cause could be a severe swelling
All of the above actions need to be absent to
of the brain, maybe after a fall or road traffic
declare brain stem death.
accident or it could be due to a large bleed in
the brain.
What causes brain stem death?
How is brain stem death
diagnosed?
What is the brain stem?
The brain stem is the part of the brain that
controls all our vital functions that keep us
alive such as breathing, heart rate and
consciousness. It is at the base of the brain
and all information that is sent from the brain
to the body has to pass through the brain
stem.
The diagnosis of brain stem death involves
making a distinction between severe brain
damage and the complete absence of brain
function. Brain stem death is diagnosed by a
consultant and another senior doctor, who
have both been trained to perform brain stem
death tests.
The tests are based on strict and legally
accepted guidelines. The tests are carried
out twice with an interval between each set
of tests. If both tests confirm brainstem
death, then the time when the first set of
tests was completed is given as the actual
time of death.
www.mcht.nhs.uk
Why does the heart continue to
beat and chest continue to move?
The chest is rising because the ventilator is
pushing oxygen in and out of the lungs. The
heart will continue to beat for a short time
whilst oxygen is reaching it. Although organs
continue to function for a while, there is no
chance of recovery.