The Role of the Respiratory Therapist in Organ Donation The ...

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O2 Challenge • Place patient on 100% FIO2 with 5cm PEEP for 30 minutes • After 30 minutes draw an ABG & switch FIO2 back to original setting • Lung Transplant Surgeons are looking for PaO2 >300 What is DCD • Formerly called Non-Heart-Beating-Donation, Donation After Cardiac Death has been an end-of-life option for patients and families for than 30 years. • After the decision has been made that the patient has no chance of survival and the family has decided to withdraw life support, the Sharing Network is contacted and evaluates the patient for medical suitability. If patient is suitable, the family is offered the option of DCD. • It is the recovery of organs from those patients who do not meet the criteria of brain death. Usually, these patients have suffered a severe, irreversible brain injury, but retain some brain stem activity DCD is Not a New Process…… • Kidney transplants began in the 1950s • Early recoveries were from DCD donors • Brain death criteria established in 1960s • Recent renewed interest in DCD-the waiting list is ever growing! 12
SCORE: 8-12 High Risk for continuing to breathe after extubation 13-18 Moderate Risk for continuing to breathe after extubation 19-24 Low Risk for continuing to breathe after extubation DCD TOOL • Prior to the test record the BP, Pulse, O2 sat • Disconnect the patient from the ventilator • After 5 minutes and 10 minutes record the following: – BP, Pulse, O2 sat, respiratory effort (yes or no), respiratory rate, Tidal volume, NIF • If patient becomes unstable (O2 sat 40 3 2 – Tidal Volume Tidal Volume > 200ml 1 Tidal Volume < 200ml 3 3 – Negative Inspiratory Force (NIF) NIF > -20cmH2O 1 NIF -1 to -20cmH2O 3 ****No Spontaneous Respirations automatic 9 5 - BMI 30 3 6 - Vasopressors No Vasopressors 1 Single Vasopressor 2 Multiple Vasopressors 3 7 - Patient Age 0-30 1 31-50 2 51 + 3 8 - Intubation Endotracheal Tube 3 Tracheostomy 1 9 - Oxygenation After 10 Minutes O2 Sat. > 90% 1 O2 Sat. 80-89% 2 O2 Sat. < 79% 3 10- Leak Test: Present Absent Total Score → Date of Extubation: Date of Expiration: Time of Extubation: Time of Expiration: Total Time: Formula for Calculating BMI BMI = (_________weight in pounds__________) X 703 (Height in inches) X (Height in inches) 13
Page 1 and 2: The Role of the Respiratory Therapi
Page 3 and 4: Incidence of Brain Death • About
Page 5 and 6: The Consent • Family assessment-l
Page 7 and 8: New Jersey Legal Definition • “
Page 9 and 10: The Apnea Test • A method to dete
Page 11: How can you help • Help overcome

The Role of the Respiratory Therapist in Organ Donation The ...

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