Analysis on the training effect of criteria and practical guidance for determination of brain death: evoked potentials

Objective To analyze the training results of short-latency somatosensory-evoked potential (SLSEP) for brain death determination and to improve the training program. Methods A total of 101 trainees received theoretical training, simulation skills training, bedside skills training and test analysis for SLSEP in brain death determination. The composition of trainees was analyzed and the error rates of 6 knowledge points were calculated. Univariate and multivariate backward Logistic regression analyses were used to analyze the influence of factors including sex, age, specialty, professional category, professional qualification and hospital level, on the error rates. Results Among them, trainees of 30-49 years old occupied 76.24% (77/101), most of them were from third grade, grade A hospitals (98.02%, 99/101), and 78 trainees (77.23%) were from Department of Neurology. There were 82 clinicians (81.19%), 31 (30.69%) had senior certificate and 42 (41.58%) had intermediate certificate. Total error rate of 6 knowledge points was 4.50% (91/2020). Of the 6 knowledge points, the error rate of pitfalls was the highest (9.41%, 19/202), followed by result determination (5.94% , 12/202), recording techniques (4.75% , 24/505), procedures (3.96%, 32/808), sequence of confirmatory tests (1.98%, 2/101) and environmental conditions (0.99%, 2/202). Univariate and multivariate Logistic regression analyses showed that age (OR = 1.566, 95% CI: 1.116-2.197; P = 0.009) and professional qualification (OR = 1.669, 95% CI: 1.163-2.397; P = 0.005) were independent risk factors associated with high error rates. Conclusions The differences between brain death determination and routine check of SLSEP should be paid more attention to improve the quality of determination for brain death by SLSEP.