Operating Room

The RSC begins preparing the operating room (OR) staff as soon as the donor process begins in the intensive care unit (ICU). Informing the OR charge nurse that a potential donor is in hospital is critical because this allows time to prepare the staff that will be working in the donor OR. The RSC can also facilitate the OR staff's preparation by educating them regarding the process. The most critical information is the timing of the OR procedure which initially can only be estimated at six to eight hours after the ICU process begins. The staff needs to understand that this time estimate may change due to donor stability, number of organs recovered, and location of the recovery teams. The next most important information involves staffing needs for the OR. A circulating nurse, scrub tech or nurse and anesthesia are needed.9 Some OPOs have RSC staff members with OR backgrounds that may assist if an emergency should occur that would not allow for the donor hospital to staff the OR. However, if the OPO has no one with a background in the OR, the recovery teams will wait until a team can be provided. This happens often when the donor recovery extends into weekday OR schedules.

A case card can also be provided to the OR staff that lists all of the supplies and equipment required for the organ recovery. Hospital-specific supplies that need to be pulled for the case may include basic laporatomy vascular instruments, light handles and bovie pads. The case card may also include a scenario of the sequence of events during the recovery process in the OR.

The RSC brings specialized supplies for the recovery. Some OPOs use premade OR packs, which shorten preparation time by having most of the required supplies opened onto the sterile field quickly. The RSC may also bring abdominal and chest retractors made specifically for organ recoveries. Preservation solutions are brought by the RSC for flushing the organs and they are kept cold until the surgeon(s) inserts the cannulas for flushing.

The RSC can help the staff prepare by going to the OR about one hour prior to case start time. The RSC should inform the staff regarding how long the case may last, what organs are to be recovered and the names of the surgeons coming to recover the organs. The RSC may also help obtain supplies such as extra back tables and IV poles.

If time allows once the OR case is complete, the RSC may assist with morgue care. If the donor's body is going to the medical examiner's office for an autopsy, all the IV lines and Foley must remain in place and tied off. The RSC may not be able to fully assist with morgue care if he or she needs to fly back with the recovery team.

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