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Michael McManus, MD, MA Munson Medical Center Bioethics Coordinator Institutional Review Chair

Michael McManus, MD, MA Munson Medical Center Bioethics Coordinator Institutional Review Chair. Due Diligence . Before implementing a DCD policy, meetings were held with: ICU Social Work CCU Operating Room Cardiologists Hospitalists Intensivists Respiratory Therapy

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Michael McManus, MD, MA Munson Medical Center Bioethics Coordinator Institutional Review Chair

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  1. Michael McManus, MD, MA Munson Medical Center Bioethics Coordinator Institutional Review Chair

  2. Due Diligence • Before implementing a DCD policy, meetings were held with: ICU Social Work CCU Operating Room Cardiologists Hospitalists Intensivists Respiratory Therapy Neurologists

  3. Due Diligence • After listening to departmental concerns, revisions were made in the policy and it was approved by: • Medical Executive Committee • Hospital Board Conscientious opt-out was part of the policy.

  4. Mock DCD A mock DCD drill was held in February 2007 and a follow-up in March 2008. All of the above participated as a 'donor' was taken to the OR area, life support was withdrawn, death was declared and organs were recovered.

  5. Follow Up on Mock DCD As a result of this, modifications were made in addressing family concerns, OR comfort with withdrawl A 'kit' was made up of all medications, supplies needed by the treating team.

  6. DCD “Kit” - Nursing • Death certificate • Sign on to electronic chart in OR prior to going to OR • Transport monitor • Rhythm strip sheet • IV fluids – including narcotics and other IV fluids to last t2 hours • Extra drugs, syringes needed for comfort care • Washcloths/towels for extubation • Tissue boxes available for family if they are to be present for extubation • Heparin 30,000 units (300 units per kilo)

  7. DCD “Kit” – Respiratory Therapy • Ambu Bag for transport • Suction supplies • Adhesive remover/Scissors • Oxygen tank for transport • Portable ventilator

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