Jennifer Muriett, MSN, RN, CPTC Director of Organ Recovery Donor Network of Arizona

 Review indications for rapid organ recovery  Define different levels of expedited cases  Identify resources needed  Describe challenges and solutions

 Family time constraints  Exhaustion  UNOS rules on approach  Critically unstable donor  Hospital/Medical examiner requirements  Surgeon availability

 DNA definition: <8hrs from authorization to withdraw  Levels of expedition  < 5hrs =  Between 5-8 hrs

 Required:  Authorization, UNOS ID, death, surgeon, OR  Useful:  Additional ORC  Hospital development support  Family services support  Supplies  Kidney pumps

 Establish what’s possible  Hospital location and capabilities ▪ OR availability  Surgeon availability  Staff availability  Remote EMR  Discuss with family  Call in the troops!

 Draw blood  Serologies  HLA  Organ/tissue requirements  Medical examiner requirements  Send labs  CMP, UA, PT/PTT, CBC, cultures  Donor assessment  OME clearance  Photos?  Huddles  ICU  OR

Authorization MSHQ Family support Planning for withdrawal process Negotiation

Notify hospital administration Coordinate OR Identify & coordinate declaring physician

 Assist  EMR entry  Remind  Establish priority  Final check before withdraw  Respond?

 Serology on referral  Donor designation  Any patient suitable  Dedicated procurement surgeon