BRAIN DEATH DONATION CHECKLIST
FOR OPERATING ROOM NURSES
Before the patient enters the OR
□ 1. Get your case cart
□ 2. Case cart should include the following:
- Major Pack
- Organ Recovery Instrument Set
- Major basin and several transfer basins
- Sarns saw
- Bone wax
- Shroud pack
- Other Miscellaneous items will be provided by Washington Regional Transplant
Community (WRTC)
□ 3. WRTC will provide you with retractors. Flash the retractors before and after
the case. Remember to log into the autoclave flash book and remember to place
patient labels for both flashes
□ 4. Count instruments, sharps, sponges, etc. per hospital policy.
□ 5. Additional equipment:
- Bovie machine x2
- Sarns saw motor (the chest will always be opened)
- If the lungs are being recovered, have the bronch set up
- Additional back tables for the different organs, coordinate with WRTC
- Slush drape and slush machine (if recovering the heart)
At this point you should speak with the WRTC coordinator to get any questions
answered and ensure that the Team has everything needed for the procedure
□ 6. Call the RN from the floor if you need to exchange information. If you need
more assistance, have the charge nurse call and get the information for you
After the patient enters the OR
□ 7. Check the patient’s ID band and identify patient per policy. The MR# stays the
same, however, the account # changes to WRTC’s account.
□ 8. A Boarding Pass will be used. Look for the WRTC consent (the Inova Surgical
Consent form is not used). An Anesthesia consent is not required. If you have
any questions, ask the WRTC coordinator for guidance.
□ 9. Check for the Declaration of Brain Death notes. There should be two physician
notes, or the Brain Death Examination Checklist will be used.
□ 10. Document who declared the patient dead along with the date and time in USA
Documentation (OR documentation system)
□ 11. Position the patient supine with bilateral arms tucked
□ 12. Prep the patient from chin to mid thighs (Clipper prep, Chloraprep from chin
to mid thighs). Wide is better
□ 13. The scrub nurse, surgeons, assistants will then scrub and gown up
□ 14. The patient is draped.
□ 15. Surgical Pause as per hospital policy
□ 16. Organ recovery procedure takes place.
Preop and Postop Dx: Brain Death
□ 17. Document all team members who are present in the OR (the WRTC
Coordinator can provide the names)
□ 18. The Death Checklist will be started from the unit the patient came from and
will be completed in the O.R
At the end of the procedure, provide post mortem care. If it is a Medical Examiner
Case (an autopsy has to be performed) leave all lines in place and cap off. Otherwise
you may D/C all the lines (per Decedent Affairs). Pt will be taken to morgue in
morgue cart. If another team will be procuring skin, bone, and tissue, leave the
patient in the room, take case cart out and specimens (for pathology), and WRTC will
help to clean up and will take over patient care from that point.