【体外膜肺ECMO精品课件】Donation After Cardiac Death.ppt

Donation After Cardiac Death May 26, 2010 Margie Whittaker, RN MSN Anne’s Story RN colleague collapsed while at work SAH with extensive bleeding Poor prognosis Family wishes to donate organs to honor Anne Did not progress to brain death After 48 hours of waiting, withdrawal of life support occurred and Anne died within about 30 minutes Fundamentally… The family / patient should make the decision to withdraw life support independent of and prior to ANY discussion regarding organ donation. History of DCD: Prior to Brain Death Laws – common practice: Kidney 1951 Liver 1961 Pancreas 1966 Heart 1967 History and Facts DCD over the years Why DCD? 100,000 people on the waiting list 17-20 people die every day DCD Organ recovery can positively impact the shortage of transplantable organs Introduction Organ donation can occur after brain death or after cardiac death DCD – potentials: The patient has a non-recoverable illness or injury and has suffered neurological devastation. Family / Patient is considering withdrawing life-sustaining treatment Process Family and medical staff begin discussions of withdrawal of life sustaining treatment. Refer the patient to OneLegacy. OneLegacy will evaluate pt for medical suitability – at this time NO APPROACH will be made. Decision Decision is made by the family to withdraw life-sustaining treatment OneLegacy will consult coroner or medical examiner for release Consent Process Effective requestor approaches Family declines donation – continue with end-of-life care process Family consents to donation – continued medical management of patient Pre-OR Continued supportive care for patient Attending MD/critical care nursing continues to manage the pt OneLegacy provides recommended parameters for donor management and lab studies OneLegacy will utilize usual process for the organ allocation. OneLegacy will collaborate/coordinate with the OR and transplant team for a timing of recovery. One