Medical Management After Brain Death
The medical management after brain death focuses on maintaining the body for a short period, either to allow family farewells or to prepare for organ donation. Although brain death marks the end of life, machines can temporarily keep the heart, lungs, and other organs functioning. This period requires specific medical protocols.
1. Stabilising vital functions
Mechanical ventilation keeps oxygen circulating. Doctors may use IV fluids and medications to maintain blood pressure. They also closely regulate temperature, electrolyte levels, and blood sugar.
2. Organ preservation (if donation is planned)
If the patient is an eligible organ donor:
- Coordination with transplant teams begins immediately
- Because time is limited, doctors quickly assess the kidneys, heart, liver, and lungs
- Healthcare teams strictly follow ethical and legal consent protocols
3. Family care and communication
Doctors and nurses continue supporting the family, offering clear updates, counselling, and guidance. Healthcare teams honour cultural and spiritual needs and allow families time to say goodbye after confirming legal death.
4. Weaning from support
Doctors gradually turn off ventilators and stop medications in a controlled, respectful setting when organ donation isn’t planned or possible. The focus shifts to comfort and dignity for the deceased and support for grieving relatives.
5. Monitoring and documentation
The medical team documents every step taken after the declaration, ensuring accurate and complete records. These include timing of assessments, legal forms, and ethical compliance.
In South African hospitals, the medical management after brain death follows standardised national protocols, though resources may vary. Inside urban hospitals, organ retrieval teams are on standby. In rural areas, the focus may be more on family support and withdrawal of care.
The medical team treats the body with dignity, supports the family, and carries out organ donation with compassion and professionalism when chosen.
👉 [Next: Living Through Loss – Coping with Brain Death in the Family]
