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ICU/ED/OR Corner: Imminent Death Referrals and Pertinent Updates
Clinical Trigger for Potential Organ Donor Referrals
The ICU and ED play a critical role in the organ donation process, as these are the areas where organ donation is possible. Therefore, it is important to recognize the clinical triggers that necessitate a call to Midwest Transplant Network in a timely manner.
Please call MTN at 1-800-DONOR91 (1-800-366-6791) within 60 minutes if your patient meets any of the following criteria. This is also reflected in your hospital policy and in conjunction with Centers for Medicaid and Medicare Conditions of Participation, and the standards for your hospital’s accrediting body.
ALL mechanically ventilated patients with:
A GCS =/<5, regardless of sedation, paralytics, hypothermia OR
Neurologic injury or devastating illness requiring mechanical ventilation OR
A shift towards comfort or palliative care discussions is anticipated.
Clinical Updates for Current or New Organ Donor Referrals
Please call MTN immediately if ANY of the following occur (either before or after initial referral call).
The care team or family anticipates end-of-life care (including advanced notice of plans to meet with family to discuss end-of-life options),
The patient’s neuro reflexes are absent,
The care team plans for neurological death (brain death) assessments, or
A family member initiates a donation discussion.
You can also find this information on MTN’s clinical trigger badge card.
Please remember:
Ideally MTN is onsite in the background for comfort care discussions with the healthcare team and family.
Should the family elect comfort care and are ready for extubation, MTN being onsite provides a smooth transition to MTN for donation conversations as your hospital’s designated requestor.
If the family chooses aggressive treatment, we will continue to follow in the background until such a time is appropriate.
Please reach out to your Hospital Services Coordinator with questions or for additional information.
