Obvious death/organ donor

[bigbaldguy]

Just curious to hear how different departments would handle a situation where you arrive on scene and find an individual suffering from obvious signs of death. Lets say a gunshot wound to the head causing massive brain damage. If that person is an organ donor and meets the criteria for donation what do you do?

 

[Aidey]

Define "meets the criteria for donation".

Are you talking about someone with or without a pulse?

 

[EMS49393]

Internal organs have to be harvested while the patient is still perfusing. The requirement is declaration of brain death after certain protocols are followed in the hospital. However, just because a person is brain dead does not mean their body is dead and a person can be kept alive by artificial means for quite some time. If the person is truly dead on scene, they are not a candidate for internal organ harvest.

Here is the upside to this, not that there is much of one. Tissue, skin, bone, and corneas can all be used post-mortem within a certain time frame. So even if they are dead, if they are fairly fresh dead they can still donate the above bodily items.

Find out who does your organ transplant coordination in your area. It's always good to have the number handy. In some states, like Missouri, they have a special team, and a person will respond to a scene to talk to the grieving family about organ and tissue donation. They are specially trained to deal with this very delicate situation. Not saying a regular EMS provider could not address this with family, but sometimes it's better to use your resources.

 

[bigbaldguy]

Define "meets the criteria for donation".

Are you talking about someone with or without a pulse?

A patient who meets the age requirements, with no iv drug use no malignancy, no transmittable decease. Who is brain dead and ventilator dependent.

no pulse

 

[Aidey]

A patient who meets the age requirements, with no iv drug use no malignancy, no transmittable decease. Who is brain dead and ventilator dependent.

no pulse

Mutually exclusive.*

Plus, we aren't able to determine most of that stuff on scene. So, you work them based on their presentation, not their organ donor status. If someone is pulseless on scene and doesn't have ROSC they are not likely to be a viable organ donor. Tissue maybe, but not organ.







*Save the random person on a LVAD or whatever.

 

[Smoke14]

A patient does not have to be perfusing to be used as a donor. Skin, bone and eyes can be harvested after death.

I have had several patients over the years that had a pulse but no respirations due to a massive head injury. I have placed a tube and ventilated them while transporting to the hospital and several of those became organ donors.

On a side note, most of them came out of crime scenes and this really makes the LEO's mad but if it changes one other persons quality of life, so be it.