Family Of High Schooler Left Brain Dead From Head Injury Prepares For Honor Walk

Team of surgeon doctors are paying respect and tribute to the organ donor after his death to save It’s been a grueling three weeks for the family of Jeremy Medina, a Gainsville, Georgia high schooler who spent two weeks in a coma after being accidentally hit on the head with a bat during baseball practice. Trauma surgeon Dr. Michael Cormican from Northeast Georgia Medical Center shared news that Jeremy Medina was declared brain dead on December 3—13 days after the senior pitcher/catcher’s traumatic experience.

He had signed up to be an organ and tissue donor, and his family is honoring his wishes. Jeremy’s final moments with his family before organ and tissue donation will be commemorated with an Honor Walk. The Honor Walk The is a time-honored tradition that families and other loved ones of donors complete as the donor is being taken to the operating room for organ harvest, which is the procurement of the donor’s organs and tissue so they can be transplanted.

Hospital staff gather in the hallways to celebrate the life and heroism of the donor and also to show how grateful they are to the donor for the priceless gift of life they are passing on. There are typically many people on for organs, and sadly many patients die before they’re matched. I still remember how grateful our family was to the organ donor who gave one of our family members the gift of life through a kidney donation back in 2020, in the midst of the Covid-19 pandemic.

Our family carefully crafted a thank you letter to the organ donor’s family, and I still don’t think we could fully express the level of gratitude we continue to have. Brain Death/Death By Neurologic Criteria I have performed numerous brain death/death by neurologic criteria evaluations and have offered second opinions on BD/DNC when the diagnosis was called into question. In all instances, I am careful to rule out other diagnoses that may be mistaken for BD/DNC, including the vegetative state, minimally conscious state and the , which is an extreme form of paralysis in which the person may be awake but the only movement they’re capable of is blinking their eyes.

People with any of these other diagnoses would not be considered brain dead. The Uniform Law Commission drafted the Uniform Determination of Death Act in 1980. The provides a legal definition of death and allows for providers from around the country to use the same set of criteria to make this diagnosis.

Despite the UDDA, there have been ethical and legal controversies which have led to numerous revisions over the years. Recently the American Academy of Neurology, American Academy of Pediatrics, Child Neurology Society and Society of Critical Care Medicine came together and agreed on a definition of brain death to provide guidance for physicians around the nation so that there could be consistency across medical providers. Hospitals should update their brain death protocols to align with the updated protocol released in .

In order to be declared brain dead, the person must have irreversible and permanent loss of the entire brain function, including the brainstem. Before proceeding to the examination, there should be an identified mechanism of brain injury that is known to lead to BD/DNC. Scans of the brain should be consistent with the mechanism and severity of brain injury.

Blood tests should be completed to make sure there are no other explanations for the patient’s neurologic status. As part of the examination, we typically start by speaking to the family or friends at the bedside to let them know what has taken place and that we will be performing an exam to evaluate the patient’s brain function. According to the guidelines, clinicians do not need to obtain consent before an evaluation for BD/DNC unless otherwise stipulated by the institution’s policy or state laws or regulations.

should be clear, concise and supportive and include simple terminology that families can understand. It is also important to note that the surgeon who would be procuring the organs in case of BD/DNC is not permitted to perform the brain death exam since this may be seen as a conflict of interest. Brain Death Examination The exam starts by observing the patient and looking to see if there is any voluntary activity or evidence of awareness.

Next the examiner will evaluate a series of reflexes known as brainstem reflexes, which includes testing the pupils for reactivity, the cornea to see if the eye blinks, a series of tests to evaluate eye movements, gag and cough reflexes, among other tests. Next the examiner administers a painful stimulation to each of the patient’s arms and each of the patient’s legs to see if the patient pulls away. Once complete, as long as the patient’s blood pressure and heart rate can tolerate it, the doctor’s may proceed to apnea testing, which is a way to see if the patient has the ability to breathe.

The doctor does this by taking the patient off the ventilator and allowing their carbon dioxide levels in their bloodstream to rise. The elevated carbon dioxide level should drive the person to take a breath if the brainstem is still intact. This is because the brainstem has sensors able to detect carbon dioxide levels and when the level gets too high, a person who is alive should be triggered to take a breath.

That is why any spontaneous breath without ventilator support means the person is not brain dead. If any part of the test cannot be completed, if there are parts of the neurological examination that are difficult to interpret or if there are metabolic derangements that are too difficult to correct, the team may decide to complete ancillary testing. These are additional tests that can be completed to verify brain death in these difficult situations.

Most of the tests evaluate for blood flow or perfusion to the brain. In the case of Jeremy Medina, he was declared BD/DNC, and because of his profound kindness, his family and loved ones will soon escort him on an honor walk as they honor his wish of giving life to others in need of organ transplantation. Although it is a tragedy for someone so young to lose his life, his legacy will be that of a hero who will positively impact the lives of many families by bestowing upon them the precious gift of life.

Anyone interested in learning more about the organ donation process can visit the . .