One fine day morning I got a call as a neurologist to confirm death before disconnecting ventilator of a young lady of 26 yrs who was admitted previous night with the history of snake bite.When I saw the patient she was on ventilator, apnoeic, pupil mid-dilated not reacting and absent doll's eye movement. So clinically I was almost sure she is gone but I just turned and said the concerned physician to do an EEG considering her age. All on a sudden I noted just a transient flexion of toes which made a shivering down my spine.
I tried my best to re- elicit the movement but in vein. I alerted the physician and team to continue support with neostigmine infusion and ASV, which they agreed on half -heartedly thinking that I am lost.But I didn't confirm brain death but ask for intensive treatment considering the possibility of a neuroparalysis of the cobra bite. I forced the less complying…
