Organ donation – emergency medicine's call to action

Healey, Andrew; Singh, Jeffrey M.

doi:10.1017/cem.2019.404

Cited by 3 publications

(2 citation statements)

References 6 publications

(10 reference statements)

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“…Given the organ donor shortage, it is essential to explore these beliefs and address healthcare provider concerns in the ED. 12…”

Section: Discussionmentioning

confidence: 99%

Solid organ donation from the emergency department – missed donor opportunities

McCallum¹,

Yip²,

Dhanani

et al. 2020

CJEM

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Objective A significant gap exists between people awaiting solid organ transplantation and solid organ donors. The purpose of this study was to determine whether there were missed donors in the emergency department (ED). Methods We performed a health records and organ donation database review of all patients dying in a large tertiary ED from November 1, 2014 to October 31, 2017 at two campuses with 160,000 visits per year. Demographic and donor suitability data were collected. The primary outcome was missed potential solid organ donors. Missed potential donors were intubated, had a pulse, and had no donation contraindications. The secondary outcome was cases where no notification was made to the organ donation organization at all. Results There were 605 deaths in the ED. Patients had a mean age of 71.1 years, 58.3% were male, and 12.4% died of a traumatic cause. There were 10 missed potential donors. Missed potential donors had a mean age of 67.4 years, 70.0% were male, and 20.0% died from trauma. In all 10 cases, patients had withdrawal of life-sustaining therapy for medical futility, and referral for donation occurred after death. Missed ED donors could have increased hospital-wide donation up to 10.6%. No notification was made in 12 (2.0%) cases; however, none of these would have been successful solid organ donors. Conclusion The ED is a source of missed organ donors. All potential donors were missed due to referral after withdrawal of life-sustaining therapy. ED physicians should consider the possibility of solid organ donation prior to the withdrawal of life-sustaining therapy.

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“…Given the organ donor shortage, it is essential to explore these beliefs and address healthcare provider concerns in the ED. 12…”

Section: Discussionmentioning

confidence: 99%

Solid organ donation from the emergency department – missed donor opportunities

McCallum¹,

Yip²,

Dhanani

et al. 2020

CJEM

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“…Given that Canadian EDs see about 15 million visits per year [ 10 ], this could potentially lead to a substantial increase in the proportion of citizens who are registered organ donors. Secondly, there is very little literature to date examining the role of the ED pertaining to organ donation promotion, but some recent studies suggest an increasing interest in strengthening the relationship between emergency medicine and organ donation [ 11 , 12 ]. In addition, a recent survey of Canadian ED patients suggests that they are accepting of the idea of organ donation registration in the ED, justifying the further study of this intervention [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Attitudes and acceptability of organ and tissue donation registration in the emergency department: a national survey of emergency physicians

et al. 2022

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Purpose There is a worldwide shortage of organs for transplantation. One method to increase the number of organs available for transplant is to increase the number of registered organ donors. The emergency department (ED) may be a suitable venue to disseminate knowledge to patients about organ donation, and to offer an immediate or future opportunity to register as an organ donor. This study aimed to assess emergency physicians’ attitudes and acceptability of an ED-based organ donation registration initiative. Methods We developed and distributed a national postal survey using a modified Dillman’s tailored design technique to a random sample of emergency physicians selected from the Canadian Medical Directory. Results From a total of 474 delivered surveys, we received 228 responses (48.1%). 98.5% of emergency physicians support the concept of deceased organ donation. 85.1% felt that the emergency department is an appropriate setting to disseminate information regarding organ donation and 77.6% felt that it is an appropriate location to offer an immediate opportunity to register as an organ donor. 74.1% of physicians who responded report to be personally registered as an organ donor. Conclusion Most emergency physicians are supportive of organ donation promotion in the ED, including offering an immediate opportunity to register. Supplementary Information The online version contains supplementary material available at 10.1007/s43678-022-00262-8.

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Croyance des directeurs médicaux sur la prise en charge des lésions cérébrales dévastatrices à la jonction entre le service d’urgence et l’unité de soins intensifs au Canada : un sondage national par établissement

Wtorek,

Weiss,

Singh

et al. 2024

Can J Anesth/J Can Anesth

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Purpose Insufficient evidence-based recommendations to guide care for patients with devastating brain injuries (DBIs) leave patients vulnerable to inconsistent practice at the emergency department (ED) and intensive care unit (ICU) interface. We sought to characterize the beliefs of Canadian emergency medicine (EM) and critical care medicine (CCM) physician site directors regarding current management practices for patients with DBI. Methods We conducted a cross-sectional survey of EM and CCM physician directors of adult EDs and ICUs across Canada (December 2022 to March 2023). Our primary outcome was the proportion of respondents who manage (or consult on) patients with DBI in the ED. We conducted subgroup analyses to compare beliefs of EM and CCM physicians. Results Of 303 eligible respondents, we received 98 (32%) completed surveys (EM physician directors, 46; CCM physician directors, 52). Most physician directors reported participating in the decision to withdraw life-sustaining measures (WLSM) for patients with DBI in the ED (80%, n = 78), but 63% of these ( n = 62) said this was infrequent. Physician directors reported that existing neuroprognostication methods are rarely sufficient to support WLSM in the ED (49%, n = 48) and believed that an ICU stay is required to improve confidence (99%, n = 97). Most (96%, n = 94) felt that providing caregiver visitation time prior to WLSM was a valid reason for ICU admission. Conclusion In our survey of Canadian EM and CCM physician directors, 80% participated in WLSM in the ED for patients with DBI. Despite this, most supported ICU admission to optimize neuroprognostication and patient-centred end-of-life care, including organ donation. Supplementary Information The online version contains supplementary material available at 10.1007/s12630-024-02749-7.

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Organ donation – emergency medicine's call to action

Cited by 3 publications

References 6 publications

Solid organ donation from the emergency department – missed donor opportunities

Solid organ donation from the emergency department – missed donor opportunities

Attitudes and acceptability of organ and tissue donation registration in the emergency department: a national survey of emergency physicians

Croyance des directeurs médicaux sur la prise en charge des lésions cérébrales dévastatrices à la jonction entre le service d’urgence et l’unité de soins intensifs au Canada : un sondage national par établissement

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