DONOR MANAGEMENT

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DONOR MANAGEMENT

• The Before does Matter!

Janet Hewson, RN Director of Trauma
Services Sherri Lamon, RN, BSN Director of
Critical Care Services
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QUESTION TO RUN ON

• What does a strong and effective
• ICU-OPO working relationship look like?

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CASE - STUDY

• Scenario
• Pt X (52yo) admitted with SIGSW (2 wounds)
• Airway / Breathing bloody secretions /
  intubated
• VS BP 60 / P 100 / RR 12 / Sats 60 / GCS 3
• Bp unattainable / P 100 / RR 10
• Neuro Pupils fixed dilated
• Conclusion
• pt wont survive could be a donor call OL
  from trauma

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CASE - STUDY

• Additional Treatment
• Increased support
• DIC - Factor VII / 6 units PRBCs / Plts / FFP /
  Cryo
• TLC L chest / A-line R wrist
• Trauma room 15 mins
• Outcome
• Resuscitation time 35mins (door ICU)
• - pt stabilized

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Pre-Hospital Donor Management

• Paramedic Education
• Airway
• Fluids
• Pressure Management
• Results
• Increased awareness
• Aggressive medical management
• Forward thinking attitude

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Trauma/ER Management

• Airway / Breathing
• Fluids / Blood Products
• Pressure Management
• Diagnostic Tests / OR
• Early Referral to OL
• Focus of patient-management
• POSITIVE OUTCOME

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Critical Care Management

• Good communication
• Involvement in initial resuscitation
• Collaboration with resources team
• Full Court Press

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Critical Care Management

• Early intensivist involvement
• Early ongoing communication and collaboration
  with OL (Huddle)
• Team approach
• Urgency family involvement
• Staff member roles
• Early consultation of specialties
• Timely BD notes
• Optimum patient management

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Critical Care Management

• Family dynamic identification
• Communication with OL (Huddle)
• Family-specific support
• Logistics
• Team-member involvements (Huddle)
• Identification of patient deterioration
• GOAL maximum aggressive medical management

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Critical Care Management

• OL collaboration with hospital
• OL communicates plans (Huddle)
• OL works closely with hospital for positive
  outcome (Huddle)

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ASSUMPTIONS

• Family will have an opportunity to make a
  decision
• Family will say yes
• Goal
• Family-centered decision-making
• allowing all End-of-Life Care options
• Save as MANY people as possible

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OUTCOME

• Consistently High Number of Organs Transplanted
  per Donor
• Case-Study Outcome
• Four Lives were saved!
• TRUE REASON for SUCCESS of OUTCOME NURSE
  DRIVEN!!!

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QUESTION TO RUN ON

• What does a strong and effective
• ICU-OPO working relationship look like?