Referral Process

Following the referral call, the RSC talks with the potential donor's bedside nurse and physician to get an overview of the patient's status. Information gathered consists of the donor's name, reason for current hospitalization, demographic information, medical and social history, and any other information offered by the medical and nursing staff. At the time of referral many OPOs send staff on site to assess the condition of the patient, review the hospital chart, and answer questions presented by the staff and family members. Common referrals include gunshot wounds to the head, cerebral vascular accidents, intracranial bleeds, head trauma, and anoxic injuries from such events as prolonged cardiopulmonary resuscitation.

The RSC first identifies the referral as an organ or tissue donation referral. For organ donation to be an option, the patient must be maintained heart beating on a ventilator. If the patient has become non-heart beating or has been removed from the ventilator, the referral is for tissue and/or eye donation.

If the referral is determined as a potential for organ donation, the referring staff may ask for on-site presence of an organ bank representative. When a referring hospital is in the metropolitan area of the OPO, on-site presence is obtainable in a timely manner. However, if outside the immediate area of the OPO office, the on-site visit may require a lengthy drive or even an airplane trip. While daytime referrals may allow for the use of commercial airlines, if commercial flights are not available, the only option for the RSC to perform an on-site evaluation may be the use of chartered aircraft.

For rural areas where a regional coordinator is not available, OPOs may have specially trained local nurses to facilitate early assessments of potential donors.3 The local nurse is contacted, informed about the situation and instructed to go on-site for review of the patient's status and chart. The RSC keeps in close contact with the local nurse to answer any questions or concerns that may arise from the donor's medical and social history. This local nurse also provides a knowledgeable person to help answer staff and family member questions.

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