ORGAN DONOR MANAGEMENT – HOSPITAL CHECKLIST (NDD)

ORGAN DONOR MANAGEMENT – HOSPITAL
CHECKLIST (NDD)
This checklist outlines BC Transplant’s information requirements for each stage of the organ
donation process. It is intended to be used by healthcare providers as a reference.
Related Documents: Organ Donor Management – Background to Recommended Guidelines
1. Identification and Referral
Call 1 877- DONOR- BC (366-6722), an ODHD Coordinator will call back immediately to determine
donation potential.
Check Organ Donor Registry
• Access webpage:https://odr.phsa.ca/
• Enter username and access code
• Enter PHN of the potential organ/tissue donor
• If a decision record exists, it will appear on the screen. If the patient is not registered, the statement will
appear in red ”Records are not available for selected criteria”
• Call BCT at 1-800-663-6189 if you encounter difficulties
Name of ODHD Coordinator______________________ Contact # ____________________
Initial Information ODHD Coordinator Will Require
Patient name, DOB, PHN
Height __________cm Weight__________kg Chest circm _____________cm Abd circm_______________ cm
Admission history, cause of death
Medical history
Blood type if available
Vital signs
Inotropes
Has Neurological Determination of Death been established?
Consent signed, who approached family? Family contact information
Note time blood drawn for TT and Serology ____________________
Draw and arrange blood to be sent for tissue typing and serology testing*
Review blood, crystalloid /colloid intake with ODHD Coordinator for hemodilution calculation
* NOTE: For Pediatric donors, consult with ODHD prior to sending blood requirements (May also require maternal blood).
2. Neurological Determination of Death (NDD)
Time of First NDD is the legal time of death
Two confirmations of NDD completed and signed
Forms ODHD Coordinator Will Require
Copies of the following to be faxed to (604) 877-2136 or 1-866-559-5594 during business hours. (After hours ODHD
may provide alternate fax number)
Signed Consent
Signed confirmation of Neurological Determination of Death Declarations X 2
Blood Group (ABO)
Completed and signed BCT Physical Assessment Form
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ORGAN DONOR MANAGEMENT – HOSPITAL
CHECKLIST (NDD)
3. Consent for Organ Donation
Consent form signed and witnessed
Family Contact information for ODHD for Medical/Social Questionnaire__________________________
Pastoral care or Social worker referral for donor family, if appropriate
Coroner notified, record name and number for ODHD________________________________________
4. Donor Screening, Maintenance and Organ Evaluation (Review requirements with ODHD)
Organ Donor Management (recommended guidelines reviewed)
Initial blood work drawn
Cultures / Sputum for Gram Stain
Urinalysis including ACR
O 2 Challenge
12 Lead ECG
CXR
Echo
Eye Care for Cornea donors (Consult with Eye Bank of BC phone # 1-800-667-2060)
Results ODHD Coordinator Will Require:
Lab work (including cultures of gram stains if available)
Chest X-ray
12 Lead ECG
Echo
O 2
Challenge
5. OR Checklist
OR timing (ODHD Coordinator will provide this information)
Chart in order and complete
Addressograph or patient labels on chart
Death Certificate completed and on chart
6. Family Follow up
Would the family like to be contacted following the recovery of the organs? Yes or No
By Whom?__________________________ Contact # for family/name________________________
7. Staff Follow up
Post case follow up / debriefing requested by hospital staff: PLEASE INFORM ODHD Coordinator
Additional Information:
__________________________________________________________________________
_____________________________________________________________________________
Please contact ODHD Coordinator with any questions or concerns during or after the case.
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