Podcast 052 – Organ Donation in the ED

Organ Donation in the Emergency Department

Though it may not seem as important as some of the things we do in ED Critical Care, managing the potential organ donor can lead to many lives saved. In this episode I interview Isaac Tawil, an Emergency Intensivist of University of New Mexico Health Sciences and associate medical director of New Mexico Organ Donor Services.

Here are the current standards for determining brain death

Wijdicks et al. Evidence-based guideline update: Determining Brain Death in Adults

Here is a video of Dr. Tawil demonstrating the brain death exam

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Comments

  1. Daniel J. Case MD says:

    Thank you, very straightforward and apropo to an EP’s needs; yet, this topic has been often ignored.

  2. Out of interest, Australia has not long introduced a program (at some fair cost) to inrease awareness of organ donation. A recent survey demonstrated that donation rates dropped in the past year despite this.
    Also, Australian Federal Police are currently investigating what might turn out to be its first case of “human trafficking for procurement of an organ.” Yipe!

    • these conversations are consistently held at the worst possible time; makes it so much harder. I think the human trafficking is going to keep getting worse. Perhaps stem cell research will make all of this academic in a couple of decades.

  3. As with so many things that don’t automatically register in our consciousness, the only way to really improve donation rates, and rates of physicians referring for possible donation, is if it made the EASIEST thing to do…and unfortunately, this is pretty unlikely to happen.

  4. Chris Johnson writes:

    Hey Scott,
    I am an avid emcrit follower. I have commented on your show a couple times and you have always been awesome. But this time I have a question. I just listened to the organ procurement episode and I was thinking: Should paramedics consider this prehospital. I mean, we call trauma codes on scene without any resus performed, and we can call medical codes after 10 mins of straight asystole or PEA. I work for a flight program in Tampa, Florida as well as a fire department. My question is should the powers that be branch out and include EMS to work codes when the possibility of saving an organ or six is feasible. or would that be wasting time, resources, and jeopardizing safety.

    Bellevue Hospital in NYC has started a program just like this. They declare the patient in the field, restart CPR, take them in a special ambulance to the ED, crash the pt on bypass with aortic blocker, and then procure the kidneys. They are studying the protocol to see if it is viable.

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