YOUR ROLE IS CRITICAL
Clinical Triggers for Donation - 1.800.247.4273
As required by CMS, JCAHO and hospital policy, all patient deaths (imminent brain death and
cardiac death) must be referred to the procurement organizations in a timely manner for donation
assessment. There are no exceptions.
Do not mention donation to the family. A Donor Coordinator will collaborate with the health
care team to develop an appropriate plan for talking with family members.
When to Call 1.800.24.SHARE (1.800.247.4273):
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Within ONE HOUR when patient meets the following clinical triggers criteria for
imminent brain death:
Patient on mechanical ventilation with a severe neuro injury and one of the following:
1. Glasgow Coma Scale (GCS) of ≤ 5;
2. Loss of 2 or more brain stem reflexes (no pupillary response, no corneal reflex, no
response to cold calorics, no doll’s eyes, no cough/gag) are documented;
3. Physicians are evaluating a diagnosis of brain death;
4. Physicians have ordered life-sustaining therapies withdrawn.
Within ONE HOUR after cardiac death (for tissue and eye donation assessment).
After initial referral, call prior to extubation or discontinuing life-sustaining therapies.
If the family mentions or has questions about donation or if you have questions.
You Must Record Referral Call Number on the Required Hospital Document
Step 1:
When making a referral call, please have
the patient chart available. You will be
asked to provide information including:
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Your name, title, unit location, phone
number, hospital name, city, and state
Patient name, age, date of birth, gender,
and race
Whether or not the patient is on a ventilator
Date and time of death
Basic medical history
Cause / nature of death
Whether or not the family has initiated a
conversation about donation
Whether or not the patient has had Sepsis,
Hepatitis B /C, HIV / AIDS, CA,
Alzheimer’s, or Parkinson’s
LifeSource – April, 2011
Step 2:
If patient meets initial donation criteria:
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A donation coordinator will be notified to
provide further assistance
The coordinator will assess the patient via
telephone
Additional information will be requested
If patient is a candidate for donation, you
will be asked to connect the family with the
donor coordinator using the Family
Connection method
Your Role in Making “The Family Connection”
Connecting the Family to LifeSource or the Minnesota Lions Eye Bank
A Donor Coordinator will evaluate the patient via the telephone and determine what donation
opportunities exist. The coordinator will inform you which of the following scenarios applies. Please
use the suggested language to connect the family to the donation coordinator. The family can
speak with the coordinator at the hospital or at home. If the family chooses to leave the hospital
before talking with a donor coordinator, please obtain telephone numbers (residence, cell, etc.)
where they can be reached within the next two hours.
No Donation Opportunities
“Usually someone would talk with you about donation, but because of
_____________, ________ is not a candidate.”
Opportunities With Donor Designation
“_______ designated his wishes to be a donor. Someone from LifeSource and
the Minnesota Lions Eye Bank will talk with you and help fulfill ___ wishes.
They will answer any questions you may have.”
Opportunities Without Donor Designation
“________ has the opportunity to help many people through tissue and eye
donation. Someone from LifeSource and the Minnesota Lions Eye Bank will
talk with you and will answer any questions you may have.”
What to say when:
Family doesn’t want to come to the phone:
“I understand this is a difficult time for you. The donation agencies will respect your
decisions and answer your questions, so you should speak with them directly.”
Family has already talked about it and decided not to donate:
“The donation agencies will respect your decisions and answer your questions, so you
should speak with them directly.”
Family wants to go home:
“That’s fine if you’d like to go home. I will need to get a number where the donation
agency can reach you within the next two hours.”
For additional information, please refer to www.mydonationresource.org.
LifeSource – April, 2011