Winter’s Wrap: Registrar Training 19.04.2017 – Organ donation, contrast nephropathy and paracetamol overdose

Organ Donation – Dr Forbes McGain (Intensivist)


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!!

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



Guidelines for writing SAQs…for registrars presenting at Footscray to incorporate into their presentation:

Guidelines for Writing the Fellowship SAQ Examination Paper


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