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Importance of the Emergency Room in the Procurement System CUCAI Chaco`s experience

Importance of the Emergency Room in the Procurement System CUCAI Chaco`s experience. Authors : Dr Christian DELLERA , Dr Dario Barrios, Dr Matias Maidana, Dr Martin Moltrasio. Introduction & Objectives.

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Importance of the Emergency Room in the Procurement System CUCAI Chaco`s experience

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  1. Importance of the Emergency Room in the Procurement System CUCAI Chaco`s experience Authors :Dr Christian DELLERA, Dr Dario Barrios, Dr Matias Maidana, Dr Martin Moltrasio

  2. Introduction & Objectives • To analyze demographic characteristics of patients (Ptes) entered to Emergency Room (ER) of 2 major public hospitals of the province of Chaco-Argentina • To evaluate their potentiality in the detection and maintenance of organ donors • To compare these data with UCI`s ones

  3. Materials & Methods • Retrospective analysis of the patients entered to sector of Emergency Room (ER) of Hospital “Dr. Perrando” and Hospital “4 de junio” of the Province of Chaco, Argentina, that were registered by the Glasgow 7 Surveillance Program using INCUCAI`s National Informatic System of Transplant (SINTRA) • Period: between 01/01/2006 and 31/12/2010. • The capacity of maintenance of organ donor was settled down like average hours and dividing the total time of internment in two intervals: I1 from entrance to diagnosis of Encephalic Death (ME) and Interval 2 (I2) from I1 to Clamp Time

  4. Results • 63 Ptes was registered. ( UCI=838 ) • Mainly with superiority of masculine sex (60%) • Breach of age between 60-69 years (23%) and 50-59 years (15%) • The main cause of entrance was Stroke (66%) followed by Encephalic Trauma (26%). • The admittance Glasgow was in its majority equal to 3 (50 %) followed by Glasgow equal to 4 (38%). • There was a 96% of total mortality discriminated in evolution to ME with 33% and cardiac arrest with 63% • During the observed period there were 15 donors: 8 tissue donors and 7 organ donors (with 71% of effectiveness). • This fact corresponded to 23 organs and 16 tissues procured. • Index organs per donant=3.2 • The I1 was 13 average hours, I2=16 hours and the total Interval average of 30 hours

  5. Results

  6. Results Main Cause of admitance p<0.0001

  7. Results Glasgow Coma Scale = 3 & 7 p<0.0001

  8. Results Evolution P<0.0001

  9. ResultsRate of single organ donation p= ns

  10. Conclusions • Is appraised the fact of including the ER in the Procurement National System. • Reaching a standard qualification of medical and nursery personnel would allow the same capacity of donor maintenance and viability of the procured organs compared with Intensive Care Unit (UCI). • It is evident that ER has older patients and mainly with lower Glasgow Coma scale compared with UCI ones, so that the Procurement Coordinator must have an early detection and an opportune intervention.

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