RESUMEN
INTRODUCTION: Timely referral of patients following asystolic death to an organ procurement organization (OPO) may increase tissue donation rates. Lack of education of health care providers and nonphysicians (admitting department) about timely referral to the OPO following asystolic death may adversely affect tissue donation rates. We hypothesized that using an in-house donation coordinator for provider education and changing the responsibility for calling the OPO from the admitting department to the licensed independent practitioner (LIP) declaring death would increase timely referral and tissue donation rates. METHODS: An education program was developed in 2005 by a newly hired in-house coordinator to highlight the importance of tissue donation. In addition, to improve timely referrals to the OPO after death, the instructions accompanying the working copy of the death certificate were altered to require the patient's LIP to call the OPO within 1 hour of death (early 2007). Rates for both timely referrals and tissue donors were modeled by a Poisson regression model with a log link function. RESULTS: Timely referral rates rose from 48% before the interventions to 72% after the intervention (P < .0001). The number of tissue donors per number of referrals also increased significantly (P = .025) over that period. CONCLUSIONS: An in-house donation coordinator initiated education program and LIP referral rather than referral by other parties following asystolic death results in higher tissue donation rates.
Asunto(s)
Personal Administrativo , Derivación y Consulta , Obtención de Tejidos y Órganos/estadística & datos numéricos , HumanosRESUMEN
Staged immersion of humans into cold water was investigated to determine whether the hyperventilation response could be reduced by this behavioral technique. A simple, two-stage procedure involving immersion to the waist for 30 s before full immersion to neck level was compared to non-staged immersion. For the staged immersion, maximum values of respiratory minute volume and respiratory frequency were significantly reduced by 35% and 38%, respectively, from the maxima observed for non-staged immersion. These results indicate that if staged immersion into cold water is possible, it can attenuate the hyperventilation response and, therefore, the probability of sudden drowning. We recommend that this knowledge be incorporated into teaching programs concerning cold water safety.