Key points:
- remember the trigger – GIVE – GCS <5; Intubated, Ventilated, End of life care
- Acute intracerebral catastrophe (eg bleed) is the most likely ED scenario wherein donation may be considered
- patient’s wishes regarding donation can be unknown to their family and must be broached sensitively
- discussions regarding donation may be appropriately deferred to the ICU team or the on-call Donation co-ordinator (phone number found via ICU) to maintain separation between ED care-givers and the Donation team
- Brain death testing is usually deferred to ICU
- Donation after circulatory death is an extremely unlikely ED outcome
- observe the fewer absolute contraindications to donation eg. active malignancy, HIV, age > 80