Care for Potential Brain-Dead Organ Donors in an Adult Emergency Room: A Convergent Care Perspective

Flores, Cíntia Maria Lovato; Silva, Rosângela Marion da; Tamiozzo, Juliana; Coelho, Alexa Pupiara Flores; Silva, Denise Maria Guerreiro Vieira da; Zamberlan, Cláudia; Camponogara, Silviamar

doi:10.1590/1980-265x-tce-2023-0032en

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…Between 2013 and 2017, there were 18,905 patients admitted to a hospital with an ICD-10 diagnosis that could have ended in brain death and who were discharged as dead. Sixty percent of them (11,412) were younger than 76 years old.…”

Section: Approachmentioning

confidence: 99%

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The The Scarcity of Organ Donors in Chile: How ER and ICU Professionals Can Make a Difference

Cohens,

Cid,

Droguett

et al. 2023

MRAJ

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Background: Despite appropriate legislation and adequate financial coverage, organ donation rates in Chile remain low. Experts blame high familial refusal rates, while dismissing the effect of procurement process inefficiencies. Our objective is to study some of those inefficiencies. Methods: Using a two-step approach, we started by obtaining two datasets, hospital discharges and organ procurements between years 2013-2017. We considered all patients that entered the system with a critical neurological condition according to ICD10, and exited dead; and all possible organ donors who entered procurement follow-up. Second, we administered a survey on healthcare professionals (physicians and registered nurses) in ER and ICU of 3 large hospitals in the capital, which aimed at describing procurement process knowledge and behavior. We used descriptive statistics for the analysis of both approaches. Results: At the first analysis we found that 87% of patients qualifying as possible donors never entered procurement follow-up and, as 50% of families refused to donate, 6% of all possible donors became effective organ donors. The survey was answered by 88 professionals. 50% physicians, 70% from ER. 51% declared they’ve actively detected a possible donor but 43% referred them to the Local Procurement Coordination. 10% of the surveyed population was not sure about the validity of brain death diagnosis, and 52% never received formal training on any organ donation topic while studying. 73% thought procurement activity was important, but 40% declared not knowing enough about it. ICU professionals were more knowledgeable than ER (81% vs 23% declared more than sufficient knowledge, p<0.001). Conclusions: The insufficient knowledge of procurement activity and concepts, especially from ER professionals may explain the lack of possible donor detection and referral found at a national level. Although the small sample may not be fully representative of the target population, the findings provide the insight that the efforts to increase Chilean organ donation rates should be put in educating healthcare professionals that participate in the procurement process, or even automating and standardizing the process to stop relying on people’s knowledge.

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Section: Approachmentioning

confidence: 99%

“…Once the PD is admitted to the ICU, they must receive standard of care together with some precautions that are unique to PDs 9,10 . In the care of a critical patient, all those professionals intervene, and also from different shifts 11 . 3.…”

Section: Introductionmentioning

confidence: 99%

The The Scarcity of Organ Donors in Chile: How ER and ICU Professionals Can Make a Difference

Cohens,

Cid,

Droguett

et al. 2023

MRAJ

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Perfil Clínico E Epidemiológico De Pacientes Com Diagnóstico De Morte Encefálica Atendidos Na Emergência

Mota,

Coelho,

Studart

et al. 2024

Rev. Contemp.

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Objetivo: avaliar o perfil clínico epidemiológico de pacientes com diagnóstico de morte encefálica atendidos na emergência. Metodologia: trata-se de um estudo transversal, realizado em um hospital público de nível terciário localizado na cidade de Fortaleza. A amostra foi composta por 1.276 pacientes internados na emergência maiores de 18 anos com era do sexo feminino, com idade média de 62,2 anos. Em relação a idade, diabetes mellitus e cardiopatia, esses dados tiveram associação significativa com o desfecho clínico para morte encefálica. Com relação aos aspectos clínicos que interferem na morte encefálica observou-se que a Escala de coma de Glasgow e a reatividade pupilar mostraram relação significativa com o desfecho de ME. Conclusão: Ao avaliar o perfil clínico epidemiológico de pacientes com diagnóstico de morte encefálica atendidos na emergência, foram constatados que fatores como, idade, presença de cardiopatia, diabetes e doença renal crônica podem contribuir para o surgimento de complicações no estado de saúde e recuperação de pacientes críticos assistidos, porém não foi possível identificar relevância estatística nos dados obtidos na coleta de dados na referida pesquisa quando se comparado aos pacientes não diagnosticados.

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Care for Potential Brain-Dead Organ Donors in an Adult Emergency Room: A Convergent Care Perspective

Cited by 2 publications

References 24 publications

The The Scarcity of Organ Donors in Chile: How ER and ICU Professionals Can Make a Difference

The The Scarcity of Organ Donors in Chile: How ER and ICU Professionals Can Make a Difference

Perfil Clínico E Epidemiológico De Pacientes Com Diagnóstico De Morte Encefálica Atendidos Na Emergência

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