Emergency department
Some patients in Emergency Departments (ED) with non-survivable injuries or diseases are admitted to ICU to provide end-of-life care. Others are admitted to enable consultation with other services, e.g. Neurosurgery. Some of these patients may later donate organs.
Some patients in Emergency Departments (ED) with non-survivable injuries or diseases are admitted to ICU to provide end-of-life care. Others are admitted to enable consultation with other services, e.g. Neurosurgery. Some of these patients may later donate organs.
There are also some circumstances where patients with a non-survivable injury or disease are admitted to the ICU solely for possible organ donation. ODNZ recommends that ED staff discuss these patients with their intensivist and that ODNZ be consulted about the feasibility of donation before ICU admission is discussed with the family.
The ODNZ medical specialist can assist the intensivist and emergency physician in deciding whether donation should be discussed with the family and will discuss the:
ODNZ recommends that family discussions in the ED about possible organ donation should be conducted by someone with experience in discussing donation.
There are two types of deceased organ donation:
This is called donation after brain death (DBD) or donation after neurological determination of death (DNDD). DBD takes place in all 24 public hospital ICUs in NZ.
DBD can include:
This is called donation after circulatory death (DCD) or donation after circulatory determination of death (DCDD). DCD takes place in the ICUs credentialed for DCD. Transfer to an ICU or hospital credentialed for DCD can be facilitated.
DCD can include:
There is no upper age limit for either type of deceased organ donation.
Both types of organ donation require the donor to be on ventilatory support in an ICU. This is because the necessary processes for donation may take hours or days.
The Australia and New Zealand Intensive Care Society (ANZICS) recommends that ‘Intensivists in collaboration with donation staff, should develop local pathways so that patients with potential for organ donation who are near the end of life in other hospital departments or remote centres are referred to an intensive care unit for exploration of the possibility of organ donation.’
ODNZ is required by the Ministry of Health to ensure nationally consistent best practice in organ donation and considers that this requirement includes providing guidance on admission from ED to ICU solely for possible organ donation.
Tissue-only donation may still be possible in cases where organ donation is not. This can occur up to 48 hours after death. Patients who die outside the intensive care unit can potentially be tissue donors.
Some patients in Emergency Departments (ED) with non-survivable injuries or diseases are admitted to ICU to provide end-of-life care. Others are admitted to enable consultation with other services, e.g. Neurosurgery. Some of these patients may later donate organs.
Some patients in Emergency Departments (ED) with non-survivable injuries or diseases are admitted to ICU to provide end-of-life care. Others are admitted to enable consultation with other services, e.g. Neurosurgery. Some of these patients may later donate organs.
There are also some circumstances where patients with a non-survivable injury or disease are admitted to the ICU solely for possible organ donation. ODNZ recommends that ED staff discuss these patients with their intensivist and that ODNZ be consulted about the feasibility of donation before ICU admission is discussed with the family.
The ODNZ medical specialist can assist the intensivist and emergency physician in deciding whether donation should be discussed with the family and will discuss the:
ODNZ recommends that family discussions in the ED about possible organ donation should be conducted by someone with experience in discussing donation.
There are two types of deceased organ donation:
This is called donation after brain death (DBD) or donation after neurological determination of death (DNDD). DBD takes place in all 24 public hospital ICUs in NZ.
DBD can include:
This is called donation after circulatory death (DCD) or donation after circulatory determination of death (DCDD). DCD takes place in the ICUs credentialed for DCD. Transfer to an ICU or hospital credentialed for DCD can be facilitated.
DCD can include:
There is no upper age limit for either type of deceased organ donation.
Both types of organ donation require the donor to be on ventilatory support in an ICU. This is because the necessary processes for donation may take hours or days.
The Australia and New Zealand Intensive Care Society (ANZICS) recommends that ‘Intensivists in collaboration with donation staff, should develop local pathways so that patients with potential for organ donation who are near the end of life in other hospital departments or remote centres are referred to an intensive care unit for exploration of the possibility of organ donation.’
ODNZ is required by the Ministry of Health to ensure nationally consistent best practice in organ donation and considers that this requirement includes providing guidance on admission from ED to ICU solely for possible organ donation.
Tissue-only donation may still be possible in cases where organ donation is not. This can occur up to 48 hours after death. Patients who die outside the intensive care unit can potentially be tissue donors.