Vital donors

daedalus

daedalus

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I am reading over the organ donor section in my textbook and I have a few questions for those who are knowledgeable in this area. I understand there are two different forms of donors, vital and nonvital. I understand that to donate heart, liver, lungs, and kidneys the donor must be brain dead and have a sustaining heartbeat and respiration (usually by artificial means).

My text (mosby paramedic) says that EMS can play a role in organ donation. This is an area that I wish to be involved in later in life as well. Are there any systems out there that participate in asking a brain dead patient's family abou the possibility of donation? Can we provide resuscitation even if it is contraindicated? And lastly, what situations in the field occur where donation is a possibility.
 
There was a good article in Jems about this.

The name I think was " One patient seven lives"
 
daedalus said:
I understand that to donate heart, liver, lungs, and kidneys the donor must be brain dead
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Some people have donated one of their kindeys when they were alive.
This is an area that I wish to be involved in later in life as well. Are there any systems out there that participate in asking a brain dead patient's family abou the possibility of donation?
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PA ALS termination of resuscitation protocol says medic may consider a possibility of calling organ donation association after pronouncing the pt.
 
My wife knows and my will states that I want each and every organ possible harvested, and what's left of my body to be donated to science. Granted, my cadaver won't be quite as useful to med students without all the bits and and pieces intact, but at least they can cut open my head or something.

The wife is then told to spend what money she WOULD have spent on a funeral and have a party. Spend the money on a couple kegs, have friends over, and share what a jerk I was to buy three kegs of Busch Lite for said party as one final joke on them.

Because let's face it, that stuff is just terrible.

I don't know if I have any authority to call organ donation or if I am allowed to talk to a patients family about that. It's a very good question, and now I am going to have to e-mail a chief and ask.
 
PapaBear434 said:
My wife knows and my will states that I want each and every organ possible harvested, and what's left of my body to be donated to science. Granted, my cadaver won't be quite as useful to med students without all the bits and and pieces intact, but at least they can cut open my head or something.

The wife is then told to spend what money she WOULD have spent on a funeral and have a party. Spend the money on a couple kegs, have friends over, and share what a jerk I was to buy three kegs of Busch Lite for said party as one final joke on them.

Because let's face it, that stuff is just terrible.

I don't know if I have any authority to call organ donation or if I am allowed to talk to a patients family about that. It's a very good question, and now I am going to have to e-mail a chief and ask.
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Hehe! I like your attitude! :]
 
Most likely the majority of patients you are ever going to have that are in full arrest are not going to be candidates for organ donation. The very elderly, those with multiple prior disease processes, drug intoxication, overdoses etc.

The patients that are going to be potentially viable organ donors are usually non elderly traumatic arrest patients. Especially those with isolated head trauma. I've had a couple of these isolated head trauma patients that turned into organ donors because all their other organs were ok, they were just brain dead.

In the field, we can't determine if someone is brain dead or not, they are either dead dead, or not dead. In my opinion unless the family asks you to stop resuscitation efforts on scene, don't even mention organ donation to them. There are people at the hospital to take care of that who are specially trained in talking to families and answering all their questions. If a patients family were to ask me on scene to stop resuscitation, and it was a situation where it would be within my protocols to stop I would probably inform them that if we continue our efforts and transport the patient to the hospital the hospital may approach them about the possibility of organ donation.

That is probably the only situation I can think of where I would ever broach the situation myself with the family, and even then all the stars would have to align for me to do it.

What do you mean my contraindicated? If they are decapitated, I would say no, because there is no way to keep the body alive long enough to harvest the organs.
 
Actually, many of the organs and precurement can be achieved much more than most expect. Bones, skin, tissue, retinas, etc can be harvested several hours after death. Yes, those parts are just as important as the more notarized ones.

The way I look at it is; you rather for them to be used and give a better life to someone or be used as worm dirt?

R/r911
 
My instructions are that I am to be 'parted out like an old Chevy' then to burn the leftovers.

Point to consider though, even though you have an organ donor card or paperwork allowing your organs to be harvested, what they can take depends on where you die. It requires a surgeon with knowledge of how to remove the organs as well as how to put them in the one who receives them. We were told that its pretty much pointless here unless the whole body can be maintained long enough to transport to a facilty with transplant capabilities.
 
You can have whatever I didn't destroy in my life. Whatever you don't want send to the bottom of the ocean as fish food.

I belive in my state that it is a med control issue for organ donors.
 
So if we find a donor card in a wallet, and it is a traumatic young healthy arrest , we should continue resus efforts even if we know them to be futile. I suppose that is my main question.
 
There was discussion a few months ago about the possible construction of an "Organ Donation Ambulance" that would pick up patients (bodies) from homes after paramedics have called the patient. They would administer drugs, compressions (and im assuming a hypothermia protocol) and take to a hospital where a procurement team is waiting.

The ethical question lies in the fact that this ambulance may transport before the family gives consent. The article below summarizes the arguement. Any ideas if this came to fruition?
http://blogs.wsj.com/health/2008/06/06/new-york-to-test-rapid-organ-recovery-ambulance/
 
BossyCow said:
My instructions are that I am to be 'parted out like an old Chevy' then to burn the leftovers.
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My instructions are the same. Well in a different set of words lol. :P

daedalus said:
So if we find a donor card in a wallet, and it is a traumatic young healthy arrest , we should continue resus efforts even if we know them to be futile. I suppose that is my main question.
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I know if it were me as the victim (hope that would never happen) that I would want to be resuscitated until donation can be arranged. But I really don't think it is the place of EMS to be asking family members about resuscitation for the sole purpose of organ donation when there is no hope for survival. (Now if family members aren't around...) Odds are they have been through a lot already and until EMS receives training on how to approach someone about donating their family members' organs, I don't think it is the place of ems.

Just my 2 cents.
 
PapaBear434 said:
The wife is then told to spend what money she WOULD have spent on a funeral and have a party.
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A little known fact, at least here in Europe, when the lab is done with your remains and have no further use for it, whatever is left is sent back to your family for burial.
I read a news article a few years ago about a family getting their uncles bones back 9 months after he died. They were surprised as hell!

Another thing, when I was in Art School we had a big box of human skulls and bones to use for art projects, these were the bones of people who donated their bodies to science and some med school passed them on to the art school.
I would not like some art student kid messing around with my skull... lol

Another thing I would not want, THE BODY FARM!!!! Yikes!:unsure:
 
Vonny said:
A little known fact, at least here in Europe, when the lab is done with your remains and have no further use for it, whatever is left is sent back to your family for burial.
I read a news article a few years ago about a family getting their uncles bones back 9 months after he died. They were surprised as hell!

Another thing, when I was in Art School we had a big box of human skulls and bones to use for art projects, these were the bones of people who donated their bodies to science and some med school passed them on to the art school.
I would not like some art student kid messing around with my skull... lol

Another thing I would not want, THE BODY FARM!!!! Yikes!:unsure:
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That's why I won't donate my body to science. Helping save anothers life by using my body is fine, but I don't really want to be dissected.
 
My last request is to flush my ashs so I can stop up one last toilet.:wacko:
 
trevor1189 said:
That's why I won't donate my body to science. Helping save anothers life by using my body is fine, but I don't really want to be dissected.
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I'm of the mind of "I'm dead, what the hell do I care what someone does with my skull?"

Make an ashtray out of it, for all I care. :P
 
daedalus said:
So if we find a donor card in a wallet, and it is a traumatic young healthy arrest , we should continue resus efforts even if we know them to be futile. I suppose that is my main question.
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Absolutely you should continue resuscitation efforts. Our job is to try and save lives not play god and decide that this person is a donor so we should not attempt to save them. Just because someone is a donor doesn't mean you should treat them any differently then you would when someone is not. Honestly IMHO it is absolutely absurd to even think of not continuing resuscitation efforts because someone is a donor.
 
In New Jersey Organ Donors have a sticker on ther IDs or have Organ Donor Cards. Our protocol for organ donors in New Jersey is to continue treatment as normal with emphasis on perfusion.
 
EMTCop86 said:
Absolutely you should continue resuscitation efforts. Our job is to try and save lives not play god and decide that this person is a donor so we should not attempt to save them. Just because someone is a donor doesn't mean you should treat them any differently then you would when someone is not. Honestly IMHO it is absolutely absurd to even think of not continuing resuscitation efforts because someone is a donor.
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Um, Lori, dear.... He was asking, if we find someone in say, traumatic arrest, who we would normally call, if we were to find they were a donor, should we NOT call them, and ride them into the ER, working them all the way?

Or, should we proceed as if they weren't a donor, and go ahead and call them.
 
In Michigan at least, there are laws about who exactly can talk to the family about organ donation. At my hospital, only representatives from Gift-of-Life-Michigan or specially-trained and designated staff may discuss it with the family.

On the road, we transport most young, viable patients to the ER because of our proximity to such facilities. The people we call often are elderly with end-stage and multiple diseases.

Does anyone have a protocol for transporting v. non-transporting of cardiac arrest patients based on donor status?
 
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