Rapid DCD Keys To Getting It

DoneJennifer Muriett, MSN, RN, CPTCDirector of Organ RecoveryDonor Network of Arizona

Objectives

Review indications for rapid organ recovery

Define different levels of expedited cases

Identify resources needed

Describe challenges and solutions

Why rapid recovery?

Family time constraints Exhaustion UNOS rules on approach

Critically unstable donor

Hospital/Medical examiner requirements

Surgeon availability

What is expedited?

DNA definition: <8hrs from authorization to withdraw

Levels of expedition < 5hrs =

Between 5-8 hrs

Resources

Required: Authorization, UNOS ID, death, surgeon,

OR Useful:

Additional ORC Hospital development support Family services support Supplies Kidney pumps

Process

Establish what’s possible Hospital location and capabilities▪ OR availability

Surgeon availability Staff availability Remote EMR

Discuss with family

Call in the troops!

Priorities—ORC

Draw blood Serologies HLA Organ/tissue

requirements Medical examiner

requirements

Send labs CMP, UA, PT/PTT, CBC,

cultures

Donor assessment

OME clearance Photos?

Huddles ICU OR

Process—DFA

Authorization

MSHQ

Family support

Planning for withdrawal

processNegotiatio

n

Process—HDC

Notify hospital administration

Coordinate OR

Identify & coordinate declaring physician

Process—AOC

Assist EMR entry

Remind Establish priority Final check before withdraw

Respond?

Potential for the Future

Serology on referral Donor designation Any patient suitable

Dedicated procurement surgeon