By Yingying Su
In 2012, the brain injury evaluation quality control center of the National Health Commission of the people's Republic of China (BQCC / PRC / NHC) was established and attached to Xuanwu Hospital of Capital Medical University. So far, the standardized training of brain death (BD) determination in China has gone through a ten-year journey. In the past ten years, we have completed two "five-year plans," and implemented the “Xinghuo” training plan and the “Liaoyuan” training plan.
The training objectives of the “Xinghuo” training program first focus on the professional doctors (working time longer than 5 years) or technicians (working time longer than 2 years) of the five specialties with the highest probability of BD evaluation (neurologist, neurosurgeon, emergency physicians, critical care physician and Anesthetist). This training model adopts a strategy called four technologies & four steps training (FFT). The four technologies include clinical evaluation, electroencephalography (EEG), somatosensory evoked potentials (SSEP), and transcranial doppler (TCD). The four steps include theoretical teaching, bedside demonstration teaching, simulation and real person exercises, and test paper analysis. From 2013 to 2021, nearly 5000 people received professional training, of whom nearly 500 received teacher qualification training, thus completing the “Xinghuo” training program for all professionals and teachers in the Chinese mainland.
The training objectives of the “Liaoyuan” training program focus on professional technicians who have received FFT training and have certain BD evaluation experience. This training model adopts a combination of offline and online approaches, including Powerpoint teaching points and production tasks. From 2017 to 2021, based on the Chinese mainland's 29 administrative regions, the teachers’ qualification team of adult BD determination (except Qinghai, Tibet) and the teachers’ qualification team of pediatric BD determination carried out standardized training of professional and technical personnel in FFT for this region. It is expected that the assembly of a team capable of BD clinical evaluation in secondary general hospitals and BD clinical evaluation plus confirmation test evaluation in tertiary general hospitals will be completed through planned efforts over the next ten years.
China is one of the participating countries in the writing of “Determination of Brain Death/Death by Neurologic Criteria: The World Brain Death Project”. At present, it is accelerating the pace of standardized training in BD determination.