Organ Donation – Dr Forbes McGain (Intensivist)
SEE FULL PRESENTATION HERE
Brain Death vs Circulatory Death
Clinical Testing – normothermic
– Sedating drugs excluded – *Baclofen mimics brain death
– cranial nerve testing
– Apnoea test
Imaging – if inappropriate for clinical test, unstable, spinal reflexes present
ED responsibility:
Contact Donor Coordinator – ICU registrar or Consultant, or Donate Life via switchboard
Initiate conversation but ensure family aware ICU attendance is NOT too prolong life but for consideration of organ donation
consider for donation if: Brain death or imminently dying and withdrawal of cardiorespiratory support planned
Intubated and Ventilated
BP adequate for organ perfusion
No Malignancy or HIV
Age 1-80 years
Contrast Nephropathy – Dr Jamie MacGilivray
Limited evidence
Variable definition of nephropathy
Jamie’s audit showed 16 patients actually had improvement in renal function!!
http://www.sciencedirect.com/science/article/pii/S0196064416313889
In summary – understand the clinical indication for the scan requested and the timeframe within which results are needed. Renal function should not delay an appropriate CT.
Paracetamol Overdose – Dr Deb Maher
https://www.mja.com.au/sites/default/files/issues/203_05/Guidelines_paracetamol_Aus_NZ_2015.pdf
EXAM QUESTIONS
Guidelines for writing SAQs…for registrars presenting at Footscray to incorporate into their presentation:
Guidelines for Writing the Fellowship SAQ Examination Paper