Brain Death Toolkit Foreword
Brain death, or death by neurologic criteria (BD/DNC) is a medical and legal determination of death.
Although revisions to national and international guidelines have taken place over the years, the core
principles remain the same, and the concept of BD/DNC has stood the test of time. Guidelines have
become more rigorous over time, but variability in policies and practice still exist, and it is important
that education surrounding brain death keep pace with guideline updates and best practices.
In this toolkit, you will find many resources to help your understanding of BD/DNC, both conceptually
and in practice. We present here a straightforward, easily accessible set of tools for use by anyone who
may be involved in BD/DNC determination. It includes a detailed lecture with instructional videos, as
well as links to modern resources including new guidelines from the American Academy of
Neurology/American Academy of Pediatrics/Society of Critical Care Medicine/Child Neurology Society
from 2023, as well as the World Brain Death Project in 2020. A sample BD/DNC policy is provided, as
well as a detailed checklist, all updated to reflect the 2023 guidelines. This sample policy can be used as
a ready-made template for adoption at individual institutions and hospitals to quickly align with the
most up-to-date guidelines. New guidance is provided for such areas as ECMO, hypothermia, primaryposterior fossa injury, CO2 retention, pregnancy, and multiple other circumstances. We also provide
Frequently Asked Questions (FAQs) for both healthcare professionals and the general public.
Finally, we provide an online training and credentialing course, serving as a resource for practitioners
treating BD/DNC patients worldwide.
We hope you find this toolkit to be a helpful resource, and that it enables you to diagnose and declare
BD/DNC 100% of the time, furthering the mission of the Neurocritical Care Society in this domain accurately and appropriately.
David Greer MD, MA, FNCS
Panayiotis Varelas MD, PhD, FNCS
Ariane Lewis MD, FNCS
Matthew Kirschen MD, PhD, FNCS
March 2024