Clinical Triggers for Organ Donation
Call LifeCenter Northwest at 888-543-3287 before any family discussion of DNR, comfort care, or ventilator withdrawal, if patient is:
- Suffering a devastating illness or injury, and
- Lost three or more brainstem reflexes
- pupils fixed
- no cough
- no gag
- no response to painful stimuli
- no spontaneous respirations
Preserving a Patient’s Opportunity to Donate
Donation provides hope to families and assures we can follow through with the patient’s wishes. With every potential donor there is the opportunity to save several of the 22 people who die every day waiting for a transplant—but without you, that opportunity can easily be lost. Saving a life through donation isn’t possible without an invested hospital care team.
Keep three things in mind to preserve your patient’s opportunity to donate:
- What is good for the patient is good for the donor. Doing everything you can to help the patient will also help preserve their opportunity to donate.
- Remember the rules of 100s: systolic BP-100, urine output-100, PaO2-100.
- Don’t make assumptions about who can be a donor. Many situations that might have ruled out donation in the past no longer apply. Let us help determine donor suitability.
Planning the Donation Conversation with Families
We know that when families understand the good that can come from donation, they rarely say no. But donation information must be delivered in a respectful, time-sensitive manner—and with a unified approach and support from the care team and LifeCenter Northwest. We all owe that to the grieving family and to the thousands of people currently waiting for an organ, eye, or tissue transplant.
That’s why it’s so important to call LifeCenter Northwest (888-543-3287) before beginning the donation conversation with the family. You are knowledgeable about hospital policy and the patient’s family and medical information, and we are experienced and confident with the donation process and working with donor families.
Together, we can work to help the patient’s family find comfort in a difficult time.
Who should be involved in the conversation planning:
- the hospital care team:
- physician leading the family conferences and writing orders for the patient
- bedside nurse
- hospital staff specific to family support (including social work, spiritual care, palliative care)
- anyone who has interacted with the family and has knowledge to share
- the LifeCenter Northwest team:
- family support coordinator
- organ recovery coordinator
- hospital development program manager
What should be determined:
- What is the family’s understanding of the prognosis/diagnosis?
- Who are the key members of the family making decisions?
- Has there been any previous mention or discussion of donation? If so, was it positive or negative?
- Is the patient a registered donor?
- Are there any complex family dynamics?
- How long has the patient/family been in the hospital?
- Does the age and injury of the patient have any effect on the conversation?
- Who will introduce the donation coordinators to the family?
- What is good language for introducing the coordinator?
When and where planning should occur:
Once you call LifeCenter Northwest, planning for the family conversation should be ongoing. Planning is most critical just before introducing the donation coordinators to the family. To be respectful, planning should take place away from the family, in a private space on the unit or near the nurse’s station.
Click here for more detailed information regarding the specific role of physicians, nurses, and administrators in the organ and tissue donation process.