1. Specify the country you are working (OQ)
  2. Is the determination of brain death regulated by a national law? (MC: yes/no)
  3. Are national guidelines for the determination of brain death (defined by a scientific society) available? (MC: yes/no)
  4. Are clinical prerequisites checked before starting the process? (MC: no; seldom; sometimes; by law, are mandatory)
  5. Which are the clinical prerequisites routinely/mandatorily checked before starting the process? (MC: established cause of death; normal blood pressure; normal temperature; electrolytes; acid-base normality; endocrine status; absence of sedatives; absence of paralytics)
  6. How many doctors are needed for certifying brain death? (OQ: number of doctors)
  7. Who could perform brain death determination at your institution?(MC: intensivist; patient's primary attending; neurologist; neurosurgeon; other)
  8. Are the specialties of the physicians defined by law? (MC: yes/no)
  9. Could you specify the composition of the medical team defined by law? (OQ)
  10. The determination of brain death is defined: (MC: with clinical criteria; with clinical criteria + EEG; with clinical criteria + EEG + cerebral blood flow determination; with clinical criteria + cerebral blood flow determination; other)
  11. Clinical examination for defining brain death comprises: (MC: coma; absence of response to pain; apnea; oculovestibular reflex; oculocephalic reflex; corneal reflex; gag reflex; cough reflex; pupillary reflex; jaw jerk; other)
  12. Clinical examination is performed: (OQ: number of times)
  13. Distance in hours between the two examinations in adults: (OQ)
  14. Distance in hours between the two examinations in children: (OQ)
  15. The apnea test is: (MC: legally defined with pCO2 level; legally defined with apnea time; not defined; optional)
  16. In the apnea test: (MC: the starting ABG is recorded; the final pCO2 is documented with an ABG; preoxygenation is required; PEEP is maintained during apnea test; oxygen is provided during the test; if the patient becomes unstable during the apnea the test is suspended; if desaturation occurs the test is suspended and supplementary tests are required; if desaturation occurs supplementary tests are required)
  17. Indications to pursue ancillary testing include: (MC: inability to complete clinical examination; toxic drug levels; inconclusive apnea test; normal neuroimaging; chronic CO2 retention; other)
  18. Blood flow determination is: (MC: optional; mandatory, never performed; used only in selected cases)
  19. By law, blood flow is evaluated with: (MC: not defined; conventional angiography; radionuclide scintigraphy; transcranial doppler; MR angiography; CT angiography; CT perfusion)
  20. Additional tests always required by law: (MC: none; EEG; conventional angiography; radionuclide scintigraphy; transcranial doppler; somatosensory evoked potentials; MR angiography; CT angiography; CT perfusion)
  21. EEG is: (MC: never performed; optional; always performed; performed if uncertainty remains after the clinical evaluation; performed if the clinical examination is not possible; performed if the apnea test is not possible)
  22. Conventional angiography is: (MC: never performed; optional; always performed; performed if uncertainty remains after the clinical evaluation; performed if the clinical examination is not possible; performed if the apnea test is not possible)
  23. Transcranial Doppler is: (MC: never performed; optional; always performed; performed if uncertainty remains after the clinical evaluation; performed if the clinical examination is not possible; performed if the apnea test is not possible)
  24. Somatosensory evoked potentials are: (MC: never performed; optional; always performed; performed if uncertainty remains after the clinical evaluation; performed if the clinical examination is not possible; performed if the apnea test is not possible)
  25. CT angiography is: (MC: never performed; optional; always performed; performed if uncertainty remains after the clinical evaluation; performed if the clinical examination is not possible; performed if the apnea test is not possible)
  26. CT perfusion is (MC: never performed; optional; always performed; performed if uncertainty remains after the clinical evaluation; performed if the clinical examination is not possible; performed if the apnea test is not possible)
  27. Radionuclide scintigraphy is (MC: never performed; optional; always performed; performed if uncertainty remains after the clinical evaluation; performed if the clinical examination is not possible; performed if the apnea test is not possible)