Use temperature management, pupillary and corneal reflexes, and EEG reactivity together rather than leaning on one poor-prognosis sign. This chapter is about careful prognostication, not a single grim marker.

Pushing for deeper hypothermia between 32 and 34 degrees has not shown any extra benefit, though strictly preventing fever remains vital; Other clinical signs, like an absent motor response or extensor posturing, are no longer considered reliable indicators on their own; Current optimal approach is targeted temperature management maintained at 36 degrees Celsius; Your most dependable bedside indicators are the pupillary light reflexes and the corneal reflexes; While clinicians historically viewed this as a sign of an inevitably poor outcome, modern evidence indicates it is no longer a reliable standalone prognostic marker