The future role paramedics may play in organ donation is unclear, and potential ethical, legal and professional issues need to be thoroughly researched and addressed

Batt, Alan M

Morgan, Lisa

Norman, Sharon

Tomkinson, Christine B

English

Fanshawe College: FIRST (Fanshawe Innovation Research Scholarship Teaching)

Fanshawe CollegeFIRST: Fanshawe Innovation, Research, Scholarship, TeachingFaculty & Staff Publications - Public Safety School of Public Safety2016Do paramedics have a role to play in organdonation?Alan M. BattFanshawe College of Applied Arts and TechnologyChristine B. TomkinsonLisa MorganSharon NormanFollow this and additional works at: https://first.fanshawec.ca/fhcsps_publicsafety_facultystaffpublicationsThis Article is brought to you for free and open access by the School of Public Safety at FIRST: Fanshawe Innovation, Research, Scholarship, Teaching.It has been accepted for inclusion in Faculty & Staff Publications - Public Safety by an authorized administrator of FIRST: Fanshawe Innovation,Research, Scholarship, Teaching. For more information, please contact first@fanshawec.ca.Recommended CitationBatt, Alan M.; Tomkinson, Christine B.; Morgan, Lisa; and Norman, Sharon, "Do paramedics have a role to play in organ donation?"(2016). Faculty & Staff Publications - Public Safety. 35.https://first.fanshawec.ca/fhcsps_publicsafety_facultystaffpublications/351  Do paramedics have a role to play in organ donation?  Published as: Batt, A.M., Tomkinson, C., Morgan, L., Norman, S. Do paramedics have a role to play in organ donation? Transplantation. 2016;100(8):e42-e43. 10.1097/TP.0000000000001212 Alan M.Batt GradCertICP MSc(c), Christine B. Tomkinson BMBS BSc, Lisa Morgan DipN BSc, Sharon Norman RNDip MBA. As readers are aware, many jurisdictions rely on paramedics to deliver ambulance services, emergency and urgent care, and as healthcare professionals, they have a duty of care to their patients. Does this duty of care include facilitating organ donation and patient’s wishes, if known or made known? Should paramedics play a role in identification and management of potential donors? Paramedics are not traditionally involved in organ donation, but in light of their changing role, it is not unreasonable to assume that they might well be in the near future.  Previous literature advised paramedics that resuscitation efforts should be performed in patients where a return of cardiac activity is considered possible and not expanded for the purposes of potential organ donation.(1) In the context of protocols for the termination of unsuccessful resuscitation attempts, do we perhaps need to revisit the concept of field termination, with a view to facilitating DCD? The complex regulatory framework and logistics involved in such a process is one of the major obstacles preventing implementation of this in many countries. They may be able to play an important role with regards to the selection of an appropriate receiving facility, and optimisation of a potential donor’s cardiovascular status during transfer. This would likely reduce the timeframe from identification to retrieval, although this has not been researched in the literature. The fact that uncontrolled DCD is not well-regulated in many countries may place paramedics in an ethical, and legal grey-area, with little to guide their actions. As such, 2  paramedics would need to be provided with clear protocols and appropriate education surrounding identification of potential DCD donors, activation of the DCD donor pathway, and therapeutic communication with the donor’s family. Paramedic education does not currently address these items. Paramedics may already be involved in the organ donation pathway, perhaps unknown to themselves. Inter-facility transfer for the purposes of organ donation is justified, if it is in the best interests of the patient and if required resources are only available in another facility.(2) Paramedics should be involved in the discussions surrounding the care of these patients as there could be significant practical, resource and communication problems that may arise. Community based paramedics may be ideally placed to identify donors and facilitate the early retrieval of tissue such as skin, whole eyes and corneas, which should take place as soon as possible after death (3). In summary, the future role paramedics may play in organ donation is unclear, and potential ethical, legal and professional issues need to be thoroughly researched and addressed. REFERENCES 1.  Roberts K. Organ donation after death in the community or emergency. J Paramed Pract. 2012;4(3):141–5.  2.  UK Donation Ethics Committee, Academy of Medical Royal Colleges. An Ethical Framework for Controlled Donation After Circulatory Death. 2011.  3.  Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee. 21.1: General considerations for tissue donation [Internet]. Guidelines for the Blood Transfusion Services. 2015 [cited 2016 Jan 25]. Available from: http://www.transfusionguidelines.org/red-book/chapter-21-tissue-banking-tissue-retrieval-and-processing/21-1-general-considerations 

Do paramedics have a role to play in organ donation?

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Do paramedics have a role to play in organ donation?

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