Brain Death hi eng nge ni? A awlsam zawngin sawi ila!

Mi pakhat "brain dead" emaw "brain death" emaw a nih thu i hre tawh em? I ṭhian pakhat chunga chutiang thil a thlen khan, "Machine-ah a la thawk a, engtin nge a thih theih ang?" Hei hi a takah chuan thil buaithlak tak leh lungchhiatthlak tak a ni. Chuvangin vawiinah hian he thluak thihna, a nih loh leh `(Brain Death)` chungchang hi i hriatthiam theih tur awlsam takin i sawi dawn nia.

Thluak thihna chu eng nge ni tak tak?

A awlsam zawngin sawi ila, thluak thihna chu i thluak hnathawh a chawlhsan vek hian a ni. Hei hi damdawi lam leh dan lamah pawh thihna anga ngaih a ni. Kan thluak hi taksa peng mak tak a ni. A ṭhen hnih nei angin kan ngai thei. Pakhat chu thluak zung, a nih loh leh ``Brainstem'' a ni. Hei hi nunna hna pawimawh tak tak, thawk leh thinlung thawkte thununtu a ni. A dang chu thluak chunglam a ni. Hei hi kan mit hmuhna, hriatna, khawih, ngaihtuahna, kal leh thusawi te thununtu a ni.

Chuvangin, thluak thihna a nih chuan natna khirh tak emaw, accident emaw chuan thluak pumpui (brain stem pawh tel) chu tihchhiat theih loh a thlen a ni. Tichuan, thluak thunun heng hna pawimawh tak tak zawng zawng hi a tawp ta a ni.

A pawimawh ber chu doctor-te chuan thluak thih dan hi uluk takin an rel a, chu chu damdawi lam tehfung pawm (accepted medical criteria) atanga chhut a ni. Hei hi a chhan dang a awm loh an hriat chian hnuah chauh an ti a, chutah chuan an natna hriat chian nan special test an nei leh thin.

Hei hi mi tam tak chunga thil thleng em ni?

Ni lo, a nihna takah chuan chutiang chuan a awm lo. Entirnan, United States-a survey an neihah chuan damdawi ina thi zinga 2% vel chu thluak thihna a ni tih hmuhchhuah a ni. Chumi awmzia chu a tlem hle tihna a ni.

Thluak thihna thlentu berte chu engte nge ni?

Thluak chhiatna nasa tak, tihdanglam theih loh avanga thluak hi a thih theih chhan tam tak a awm a. I hriat angin kan thluak hian a hnathawh that theih nan thisen leh oxygen supply reng reng a mamawh a ni. Chuvangin, hliam na tak emaw, natna emaw, thluaka thisen leh oxygen kal zel tur titawptu eng pawh hian hei hi a thlen thei a ni. Tin, thluak chhunga thisen kalna kawngte a chhiat a, thisen a chhuah chuan he natna hi a thlen thei bawk. A chhan lian ber ber thenkhat chu hetiang hi a ni:

• Traumatic Brain Injury: Lu-ah na taka vuak i neih chuan , accident-ah ang chi.
• Intracerebral hemorrhage: Thluak chhungah thisen kalna kawng a puak chhuak.
• Subarachnoid Hemorrhage: Thluak chhehvel membrane inkara thisen chhuak.
• Ischemic Stroke: Thluak lama thisen phurtu thisen kalna kawng chu a inkhar a, thisen kal chu a titawp a ni.
• Heart Attack: Heart attack vangin thluaka thisen kalna a titawp a nih chuan.
• Thluak lama oxygen tlakchham (Hypoxic Ischemic Brain Injury - HIBI): Tui pil leh thawk hah ang chi thil vang a ni.
• Intracranial Infections: Entirnan, thluaka natna hrik, meningitis emaw encephalitis emaw ang chi te.

Heng zinga eng emaw avanga thluak chhiatna a nasat chuan thluak thihna a thlen thei a ni.

Doctor-te’n thluak thihna an hriat theih nan eng medical criteria nge an hman?

"Medical Criteria" tih hi doctor ten mi thluak a thi em tih hriat nan an zawm ngei ngei tur a ni. Rules set khat ang mai a ni. Mi pakhat i en mai mai a, "Aw, he mi hi thluak a thi tawh" i ti thei lo. Chumi hma chuan doctor-te chuan hengte hi an tih ngei ngei tur a ni:

• Thluak chhiatna nasa tak thlentu bulpui ber chu kan zawng chhuak a, kan enkawl ta a ni. A theih ang anga dinhmun chu thunun kan tum thin.
• Hetiang thluak chhiatna nasa tak thlen thei tur thil dang a awm loh nan fimkhur a pawimawh hle. Entirnan, damdawi thenkhat, a nih loh leh hypothermia ang chi condition te hian thluak a tichhe thei bawk. Chuvangin chutiang chu paih chhuah hmasak a ni.
• Thluak thihna ang chi natna dang a awm lo tih pawh finfiah a ni bawk.

Heng zawng zawng hi tihfel a nih a, duhthlan tur dang a awm loh tih an hriat hnuah chauh thluak thihna finfiah nan special test an hmang thin.

Thluak thihna a awm leh awm loh hriat nan eng test nge tih thin?

Heng test te hi doctor, thluak thihna chungchanga training bik nei te hian an ti thin a ni. Test vawi khat chauh a tawk lo a nih chuan test nawn leh a ngai a, chu chuan a natna hmuhchhuah chu a dik tih finfiah a ngai a ni. I chhungkuaa mi pakhatin hetiang natna hi a nei nia i rinhlelh chuan doctor-te chuan heng test leh result awm thei te hi i chhungte hnenah an hriattir hmasa ngei ang.

Taksa enfiahna leh Imaging Test te

Doctor ten damlo dinhmun tlangpui an enfiah ang. A châng chuan thluak dinhmun en nân thluak MRI ang chi imaging test pawh tih a ni thei bawk.

Neurological Examination neih a ni

Hei hi fiahna pawimawh tak a ni. Mi thluak thi tawh chuan thluak a tihchhiat hma angin thawm, eng leh khawih te chu a chhang let lo. Jerking movement engemaw zat a awm thei a, mahse hengte hi duhthlanna a ni lo va, duhthusam lo movement a ni. He neurological test neih chhung hian doctor-te chuan:

• Kawngkhar hnunglam khawih a, khuh emaw gag reflex emaw a awm leh awm loh enfiah. Thluak a thawk tha a nih chuan hei hi chhanna a awm tur a ni.
• Mit chu cotton wool phek hmangin khawih la, mit chu a khar em, a che em, a lu a hawi let em tih en rawh (eye reflexes).
• Mit mitmeng (pupil)-ah êng a eng a, a te zawk emaw, a lian zawk emaw pawh an enfiah thin. A tlangpuiin light a on chuan pupil chu a te deuh tur a ni.

Heng zinga pakhat mah chhanna a awm loh chuan thluak hnah a thawk tawh lo tihna a ni.

Thâwk lak dan enfiah (Apnea Test) .

Thluak chhiatna nasa tak nei chuan a mah chauhin a thawk thei lo. Chuvangin thawkna machine, a nih loh leh ``Ventilator'' nen an inzawm a ni. He apnea test-ah hian doctor-te chuan he ``Ventilator'' puihna hi hun rei lote chhung atan an titawp a, damlo chuan mahni chauhin thawk pakhat mah a la em tih an en thin. Brain stem hian hna a thawk a nih chuan thisena carbon dioxide level a san chuan a chhanna atan thawk lak a tum tur a ni. Thâwk lak loh chuan chu pawh chu thluak thihna finfiahna nghet tak a ni.

Test-in i thluak a thi tih a finfiah chuan eng nge thleng ang?

Pakhatnaah chuan i doctor-te chuan test result chu i chhungte hnenah an share ang a, an hrilhfiah ang. Thluak thi tih hriatchhuah chuan thihna a kawk tih an hrilhfiah bawk ang. Hei hi hriat a harsat zia chu Doctor-te chuan an hre chiang hle. I chhungte hian zawhna leh ngaihtuahna tam tak an nei dawn tih an hrethiam. Chuvangin, i chhungte hnenah heng result awmzia hrethiam turin (ulwangikkolla - hrethiam turin) hun an pe ang a, zawhna eng pawh an chhang ang.

A dawtah chuan doctor-te chuan hmalak dan tur an sawi dawn a ni. Entirnan, i nung rengtu ventilator lakchhuah chungchang. I chhungte hnenah ventilator lakchhuah a nih hmain i hmuh duh leh rei lo te i bula awm duh leh duh loh an zawt mai thei. Hei hi hun sensitive tak a ni.

Coma-a awm leh thluak thi tih hi eng nge a danglamna?

Hei hi mi tam tak tibuaitu a ni. Coma-a awm tih awmzia chu hriat lohna a ni a, mahse thluaka reflex response engemaw zat a awm thei. Entîr nân, êng êng takin mit a rawn deng chuan mit a khar thei a, lu chu a hawi let thei bawk. Chumi awmzia chu thluaka hnathawh thenkhat chu a la awm tihna a ni.

Mahse, thluak thihnaah chuan chutiang reflex response chu a awm lo. Tin, coma hi a awm reng reng lo. Mi tam zawk chu kar hnih vel chhungin coma atanga an dam leh thin. Mahse, thluak thihnaah chuan thluak hnathawh chu a bo vek a, tihdanglam theih lohvin a bo vek a, hriatna a awm leh ngai lo.

Coma-a awm chuan dam leh theihna beiseina engemaw chen a nei thei a, mahse thluak thi tawh chuan chutiang beiseina chu a nei lo. Chu chu a danglamna ber chu a ni.

Thluak thi tawh chu a dam thei ang em?

Ni lo, thluak thi tawh chu a dam thei ngai lo. Doctor-te chuan thluak thihna a thleng thei nia an rinhlelh chuan a tehna leh test dan tur kaihhruaina khauh tak tak an zawm thin. Test-naah chuan chu mi chu thluak thi a ni tih a chiang a nih chuan chu mi chu damdawi lam thiah ngaih a ni. Hei hi tihdanglam theih a ni lo.

Thluak thihna hi kan veng thei ang em?

Dik tak chuan thluak thihna hi direct-a ven theih a ni lo. A chhan chu a thlentu natna khirh tak emaw, accident emaw kan veng thei lo mai thei a ni. Mahse, natna khirh tak emaw, thluak tichhe thei hliam emaw kan neih hnua damdawi lam pan vat kan nih chuan, thluak thihna thlenga a kal zel loh nan eng emaw chen chu ven theih a ni mai thei. Mahse, tun dinhmunah chuan thluak hnathawh a chawlhsan veleh thluak thihna tur venna tur damdawi a la awm lo.

Thluak thihna thlentu thilte chu i veng thei lo nain, i damloh emaw, i hliam emaw, i thluak thi emaw a nih chuan eng nge i tih tur tih chu i ruahman lawk thei a ni. Chu chu "Advance Directive" tih hming pu legal document tihfel hmangin i ti thei ang. Hei hi nangmah ngeiin i thusawi theih loh chuan eng medical care nge i duh tih tarlanna document a ni. Entirnan, i "Advance Directive"-ah chuan i thih hnuah (thluak thihna pawh tel) i taksa peng hrang hrangte chu pek i duh thu a sawi thei.

Hei hi hriatthiam a har deuh a ni lawm ni?

Ni e, thluak thihna hi thihna kan ngaihtuah dan nen a danglam a ni. A tam zawkah chuan thihna hi kan taksa hnathawh a chawlhsan lai angin kan ngai thin. Thâwk kan chawlhsan a, kan thinlung a na a, nunna leh thihna inkar chu kan pel ta a ni.

Mahse, tunlai intensive care medicine hian he line hi a ti fiah lo hle. Tunah chuan ventilator ang chi enkawlna hmang hian thawk leh thinlung thawk chu harsatna hriatchhuah a, enkawl a nih hma chuan hun eng emaw chen chu a awm thei tawh a ni. Chuvangin, thawk chhuak anga lang leh thinlung na tak tak nei chu a thi tak tak a ni tih hi pawm a harsa thei hle.

Chu chu thluak thihna hmuchhuaktu doctor-te chuan an hrethiam hle. Mi pakhat chu thluak thi a ni tih an thutlukna siam hmain an fimkhur dante sawifiah turin hun an hmang fo thin.

He thawnthu atang hian kan hriat reng tur thil (Take-Home Message) .

Okay, chuvangin vawiin a kan sawiho pawimawh tak tak thenkhat hi han sawi nawn leh ila:

• Thluak thihna hi thihna dik tak a ni. Dan leh damdawiin a pawm thihna a ni.
• He diagnosis hi uluk takin an siam a, chu chu methodology pawm tawh angin a ni. Test pakhat hmang ni lovin, test engemaw zat hmanga finfiah a ni.
• Hei hi coma nen chuan a danglam vek a ni. Coma atanga dam leh theihna chance a awm laiin, thluak a thih hnuah chuan kir lehna tur a awm tawh lo.
• Ventilator hian taksa hnathawh thenkhat (thâwk, thinlung thawk) chu hun eng emaw chen vawng reng mah se, thluak hi a thawk thei lo vek a ni.
• Hetiang hunah hian chhungkua tan he dinhmun hi hriatthiam leh pawm a harsa hle. Chuvangin hmangaihna, ngilneihna leh hriatthiamna pek hi a pawimawh hle.

He thu hian thluak thihna chungchanga thupui buaithlak tak hriatthiamna engemaw chen i neih theih ka beisei.

`Thluak thi, Thluak thi, Coma, Ventilator, Thluak hliam, Thihna finfiahna, Medical test te