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In order to provide uniformity in hospital policies and physician practice with respect to brain death diagnosis and management for the purpose of organ donation, Section VII.5 - Certification of Brain Death of AO 2010-0019 shall be amended. The amendments are based on the 2017 Revised Philippine Neurological Association (PNA) Brain Death Criteria which were finalized by the PNA Ad Hoc Committee on Brain Death and was subsequently approved and released last June 2017 during the PNA Midyear Convention. The revised criteria shall  be  utilized  only  in  the  determination  of  eligibility  for  deceased  organ donation and not for neurological prognostication. Below shall be the amendments to the existing provisions of Section VII.5:

From:
VII. Operational Guidelines

5.   Certification of Brain Death

a.1  They shall determine and establish brain death based on existing guidelines (Ref: Philippine Neurological Association (PNA); Canada Practice Guidelines for the Diagnosis of Brain Death).

To:
VII. Operational Guidelines

5.   Certification of Brain Death

a.1. These  two  (2)  physicians  who  should  preferably  be,  but  not necessarily limited to, a neurologist or neurosurgeon or internist or anesthesiologist shall determine and establish brain death based on existing guidelines (Ref: 2017 Philippine Neurological Association (PNA) Revised Brain Death Criteria).

From:
VII. Operational Guidelines

5.   Certification of Brain Death

a.2 A second evaluation by the same two (2) physicians must be performed after an interval of at least two (2) hours (Ref: Canada Practice Guidelines for the Diagnosis of Brain Death).

To:
 
VII. Operational Guidelines

5.   Certification of Brain Death

a.2  xxx  at  least  four  (4)  hours  (Ref:  2017  Philippine  Neurological Association (PNA) Revised Brain Death Criteria).

From:

VII. Operational Guidelines

5.   Certification of Brain Death

a.4  A Death Certificate shall be signed by the Attending Physician (AP). The date and time of death is recorded on the Death Certificate and in the patient’s chart. The time of death is when the patient is initially declared brain dead.

To:

VII  Operational Guidelines

5.   Certification of Brain Death

a.4  A Death Certificate shall be signed by the Attending Physician (AP).
The date and time of death is recorded on the Death Certificate and in the patient’s chart. The time the second declaration is made shall be the time of death. (Ref: 2017 Philippine Neurological Association (PNA) Revised Brain Death Criteria).

As thus amended, all other provisions of DOH Administrative Order No. 2010-0019 dated June 23, 2010 still stands in effect. This Order shall take effect fifteen (15) days after its publication in the Official Gazette or newspaper of general circulation.