This document discusses cerebral death and organ transplantation. It begins by defining death and cerebral death. Cerebral death is the irreversible loss of brain and brain stem functions. The diagnosis of cerebral death requires the absence of brain stem reflexes and an apnea test to confirm the lack of spontaneous breathing. The document outlines Turkey's legal regulations regarding organ donation and transplantation. It emphasizes the importance of donor care after cerebral death to sustain organs and the roles of intensive care units and nurses in the donation process. Effective communication with patient families is key to gaining consent for organ donation. The conclusion stresses minimizing donor loss to benefit more patients through transplantation.
Brain Death concepts, Its changes and life after brain death, is the body still alive?? what are the determinants of brain death and who can declare it, bio ethical dimensions of nursing care in BD
This is a review of a case of an infant admitted to pediatric ICU as a case of epidural hematoma after traumatic brain injury. A brief summary of the most important aspects. Part of the residency teaching program for pediatric residents at the pediatric and neonatology department at Istishari Arab Hospital, Ramallah, Palestine.
Nurses as the primary care providers would be the immediate health care professional to assess the patient's response and to determine whether he is improving or deteriorating. Signs of brain death can be identified and reported early by a nurse with adequate knowledge.
Brain Death concepts, Its changes and life after brain death, is the body still alive?? what are the determinants of brain death and who can declare it, bio ethical dimensions of nursing care in BD
This is a review of a case of an infant admitted to pediatric ICU as a case of epidural hematoma after traumatic brain injury. A brief summary of the most important aspects. Part of the residency teaching program for pediatric residents at the pediatric and neonatology department at Istishari Arab Hospital, Ramallah, Palestine.
Nurses as the primary care providers would be the immediate health care professional to assess the patient's response and to determine whether he is improving or deteriorating. Signs of brain death can be identified and reported early by a nurse with adequate knowledge.
COVID-19 Presenting as stroke- mechanisms, diagnosis and treatmentSudhir Kumar
Covid 19 infection can affect nervous system in many ways, including an increased risk of stroke. This presentation looks at the association of COVID 19 infection and stroke. Mechanisms of stroke in COVID 19 have been elucidated. Approach to diagnosis and management has also been discussed via case studies. Prompt diagnosis and early initiation of treatment ensures a good outcome in covid 19 infected patients presenting with stroke.
An overview of Decompression hemicraniectomy in patients with large hemispheric infarctions. The presentation touches upon definition, pathophysiology, medical management, rationale for surgery, mortality, functional outcomes of DHC, and complications in a nutshell.
Death by Neurological Criteria and Organ Donation: Bill KnightSMACC Conference
Bill Knight explains the concept of death by neurological criteria and the complexities surrounding organ donation in such situations.
Bill discusses the process of dying, the definition of death, how to approach the neurologically dead patient and how to consider organ donation.
Death is a complex topic.
Due to advancements in medical technology and processes, the definition of death is a challenging one.
Bill talks at length about the definition of death by the neurological criteria. Dying is an active process, whereas death is an event.
The acceptance of death by the neurological criteria is often challenging as Bill will highlight. Bill talks about the care of the dying or dead patient.
There is a point at which care will transition from supporting the patient to supporting the organs. This is still good care.
There is an alignment of parallel intentions – first and foremost resuscitation of patients and then failing that, proceeding to considering and actioning organ donation. This is important due to the shortage of viable donor organ worldwide.
The donation process itself is complex. Bill provides his thoughts. He insists that an intensivist be involved as this has been shown to increase the number of viable and healthy organs made available.
The timing is also important. Available evidence does not support the need for immediate procurement after brain death. Taking time to optimise perfusion and allow recovery and cardiac function is appropriate and should be done.
Bill also discusses other treatment options at the time of death such as optimising endocrine function.
Finally, Bill will provide some practical considerations when communicating with the dead patient’s family. This involves being clear on your messaging. You are supporting organs, not life.
To reinforce this point, Bill suggests not examining or talking to the patient. He also recommends using all of the available hospital support services.
Similarly, it is best to not introduce the topic of organ donation to the family yourself as the treating clinician. Utilise the Organ Procurement Organisations (or similar services) and get them involved early to speak with the family.
Join Bill Knight in his talk on the North American perspective on Organ Donation, brain death and management of the brain dead donor prior to organ donation.
For more like this, head to our podcast page. #CodaPodcast
A detailed presentation on Brain Death and Ongan transplantation.
Criteria for Brain Death are explained in detail. Legislative laws regarding the organ transplant, organ preservation are also explained.
COVID-19 Presenting as stroke- mechanisms, diagnosis and treatmentSudhir Kumar
Covid 19 infection can affect nervous system in many ways, including an increased risk of stroke. This presentation looks at the association of COVID 19 infection and stroke. Mechanisms of stroke in COVID 19 have been elucidated. Approach to diagnosis and management has also been discussed via case studies. Prompt diagnosis and early initiation of treatment ensures a good outcome in covid 19 infected patients presenting with stroke.
An overview of Decompression hemicraniectomy in patients with large hemispheric infarctions. The presentation touches upon definition, pathophysiology, medical management, rationale for surgery, mortality, functional outcomes of DHC, and complications in a nutshell.
Death by Neurological Criteria and Organ Donation: Bill KnightSMACC Conference
Bill Knight explains the concept of death by neurological criteria and the complexities surrounding organ donation in such situations.
Bill discusses the process of dying, the definition of death, how to approach the neurologically dead patient and how to consider organ donation.
Death is a complex topic.
Due to advancements in medical technology and processes, the definition of death is a challenging one.
Bill talks at length about the definition of death by the neurological criteria. Dying is an active process, whereas death is an event.
The acceptance of death by the neurological criteria is often challenging as Bill will highlight. Bill talks about the care of the dying or dead patient.
There is a point at which care will transition from supporting the patient to supporting the organs. This is still good care.
There is an alignment of parallel intentions – first and foremost resuscitation of patients and then failing that, proceeding to considering and actioning organ donation. This is important due to the shortage of viable donor organ worldwide.
The donation process itself is complex. Bill provides his thoughts. He insists that an intensivist be involved as this has been shown to increase the number of viable and healthy organs made available.
The timing is also important. Available evidence does not support the need for immediate procurement after brain death. Taking time to optimise perfusion and allow recovery and cardiac function is appropriate and should be done.
Bill also discusses other treatment options at the time of death such as optimising endocrine function.
Finally, Bill will provide some practical considerations when communicating with the dead patient’s family. This involves being clear on your messaging. You are supporting organs, not life.
To reinforce this point, Bill suggests not examining or talking to the patient. He also recommends using all of the available hospital support services.
Similarly, it is best to not introduce the topic of organ donation to the family yourself as the treating clinician. Utilise the Organ Procurement Organisations (or similar services) and get them involved early to speak with the family.
Join Bill Knight in his talk on the North American perspective on Organ Donation, brain death and management of the brain dead donor prior to organ donation.
For more like this, head to our podcast page. #CodaPodcast
A detailed presentation on Brain Death and Ongan transplantation.
Criteria for Brain Death are explained in detail. Legislative laws regarding the organ transplant, organ preservation are also explained.
Martin Smith persuades you that controversies in brain death should not, and do not, exist.
Almost fifty years since the concept of brain death was first introduced, some individuals and whole nations still struggle with its concept and justification.
Many controversies continue to surround brain death, although there is broad consensus that human death is ultimately death of the brain.
Martin provides a history of the concept of brain death. He describes how advances in modern medicine have made the concept of death, and specifically brain death, muddled. This has broad implications on the diagnosis of brain death – and provides the basis to the controversies that exist.
The concept of death as a process is explored.
The idea, and in fact the truth, is that death does not happen at a discrete moment in time.
Alive or dead may be the only two states an organism can be in. However, the transition from one to the other is not instantaneous.
Martin contends that the process and the nomenclature has little practical relevance. What is important is the point of irreversibility.
He explains how we, as a medical community, can be confident of this point.
The main points are 1) fulfilment of essential preconditions, 2) exclusions of reversible causes and 3) clinical evaluation.
In his talk Martin elaborates on each and provides some important teaching points. As he explains, this is an important concept to grasp as it has implications for your patients as well as broader societal implications in the context of organ donation.
Martin’s talk will discuss the history and development of the concepts and diagnosis of brain death internationally. He examines current challenges and controversies and makes the case for an international consensus.
For more like this, head to our podcast page. #CodaPodcast
This presentation consist information about Brain death with special emphasis to differences between Indian and Western Guidelines. Also consist information about Organ transplantation and related act.
Brain cut up for the general pathologistEffiong Akang
Simplified procedure for brain cut up examination for general pathologists that emphasises the importance of good clinicopathological correlation in post-mortem CNS examination. Presented at TSL workshop in Lagos on 25 November 2014
1
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Academic Clinical History & Physical Notes for Cerebral Ischemia
Muhammad Aftkhar
Grand Canyon University
December 04th, 2020
Academic Clinical History & Physical Notes for Cerebral Ischemia
I am presenting the academic clinical history and physical notes for the patient of ischemic stroke. Ischemic stroke or cerebral ischemia occurs when one of the cerebral arteries is blocked by the clot leading to diminished blood supply and oxygen to brain cells resulting in damage or death of brain cells (Celik et al., 2020)
History and Physical Note
1.Chief complaint/reason for admission/visit/consult.
A 52 years old male patient came to the acute care hospital with the chief complaint of sudden severe headache, dizziness, and slurred speech.
HPI for the H&P or consult notes.
The patient felt a severe burning and shooting pain in the frontal region of the head while he was reading the newspaper in the morning. The patient said that he developed blurred vision during reading. The patient felt numbness when the pain started (Harriot et al., 2020). The patient said that the pain was not subsiding with the time as it persisted since its onset. The pain scale was nine by 10, started in the frontal region, and radiated towards the temporal region. The associated symptoms with pain are nausea, vomiting, aphasia, dysarthria, apraxia, and vertigo (De Cock, et al., 2020). The symptoms become aggravate in a standing position and become alleviating when he lay down on the bed with 3 pillows. The patient felt a significant change in body posture. He is positive for facial drooping while negative for fever and chills. He finds difficulty in sitting and maintaining coordination. The patient stated that he had a medical history of neck trauma in a road accident. He was hospitalized for 3 weeks after neck surgery.
2.Medical, surgical, family, social, and allergy history.
Medical history
The patient has hypertension and hypercholesterolemia (Haegens, et al., 2018).
Surgical history
The patient underwent neck surgery after neck trauma at the age of 42.
Family history
The patient’s mother is alive and diabetic. The father of the patient died due to a cardiac stroke. His sister is normal. One of the two brothers has hypertension, and the other is normal. Currently, the patient is living with his normal wife.
Social history
The patient has a long history of smoking and boozing, coupled with a sedentary lifestyle.
Allergy history
· Raw fruits and vegetables, Shellfish, Soy.
· Amoxicillin and aspirin.
3.Home medications, including dosages, route, frequency, and current medications, if a consultation note.
Antihypertensive drugs Edarbi & Hygroton.
40 mg oral Edarbi once a day, as the patient is on diuretics, Hygroton. Oral 50 mg Hygroton once in the morning.
Hypercholesterolemic drugs Lipitor
Oral tablet 40 mg once a day. He takes this tablet at night.
4.Review of systems with all body systems for H&P or consult notes. Review of systems i ...
1
15
Academic Clinical History & Physical Notes for Cerebral Ischemia
Muhammad Aftkhar
Grand Canyon University
December 04th, 2020
Academic Clinical History & Physical Notes for Cerebral Ischemia
I am presenting the academic clinical history and physical notes for the patient of ischemic stroke. Ischemic stroke or cerebral ischemia occurs when one of the cerebral arteries is blocked by the clot leading to diminished blood supply and oxygen to brain cells resulting in damage or death of brain cells (Celik et al., 2020)
History and Physical Note
1.Chief complaint/reason for admission/visit/consult.
A 52 years old male patient came to the acute care hospital with the chief complaint of sudden severe headache, dizziness, and slurred speech.
HPI for the H&P or consult notes.
The patient felt a severe burning and shooting pain in the frontal region of the head while he was reading the newspaper in the morning. The patient said that he developed blurred vision during reading. The patient felt numbness when the pain started (Harriot et al., 2020). The patient said that the pain was not subsiding with the time as it persisted since its onset. The pain scale was nine by 10, started in the frontal region, and radiated towards the temporal region. The associated symptoms with pain are nausea, vomiting, aphasia, dysarthria, apraxia, and vertigo (De Cock, et al., 2020). The symptoms become aggravate in a standing position and become alleviating when he lay down on the bed with 3 pillows. The patient felt a significant change in body posture. He is positive for facial drooping while negative for fever and chills. He finds difficulty in sitting and maintaining coordination. The patient stated that he had a medical history of neck trauma in a road accident. He was hospitalized for 3 weeks after neck surgery.
2.Medical, surgical, family, social, and allergy history.
Medical history
The patient has hypertension and hypercholesterolemia (Haegens, et al., 2018).
Surgical history
The patient underwent neck surgery after neck trauma at the age of 42.
Family history
The patient’s mother is alive and diabetic. The father of the patient died due to a cardiac stroke. His sister is normal. One of the two brothers has hypertension, and the other is normal. Currently, the patient is living with his normal wife.
Social history
The patient has a long history of smoking and boozing, coupled with a sedentary lifestyle.
Allergy history
· Raw fruits and vegetables, Shellfish, Soy.
· Amoxicillin and aspirin.
3.Home medications, including dosages, route, frequency, and current medications, if a consultation note.
Antihypertensive drugs Edarbi & Hygroton.
40 mg oral Edarbi once a day, as the patient is on diuretics, Hygroton. Oral 50 mg Hygroton once in the morning.
Hypercholesterolemic drugs Lipitor
Oral tablet 40 mg once a day. He takes this tablet at night.
4.Review of systems with all body systems for H&P or consult notes. Review of systems i ...
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. CONTENT
Death
Celebral Death
Donor Care
Transplantation
Results
3. WHAT IS DEATH?
Cardiopulmonary Death
It is the arrest in the cardiac functions
and adiaphoresis.
Celebral Death
Cerebral death is the death of brain cells.
4. DEFINITION OF DEATH FOR AES
((American Electroencephalograpic
DEATH :
Theirreversible arrest of respiration and
circulation
The irreversible arrest of brain and brain
stem reflexes
Brain blood supply exists but oedema
continues and after a while, circulation
fails and blood suppy stops.
6. HISTORY OF CELEBRAL DEATH
1959: Dr. Mallret Le Coma Depasse
1968: Harvard University
1976: Royal Medicine Collage
1981: President’s Commission
1995: Neurology Academy
7. CEREBRAL DEATH PERSISTENT VEGETATIVE STATE
*connected to
respiratory tract
* loss in 24-36 hours
*Impossible to revive
*Patient continues to
aspirate
*The patients may live
for months or even
years
*The patients may have
the chance of survival in
some cases.
* The patients react to
painful stimulus
8. DIAGNOSIS OF CEREBRAL
DEATH
*While it seems very related among the
countries, there are some differences
with respect to the diagnosis tests.
*After diagnosed with cerebral death
clinically in Turkey, they run an apnea
test and the diagnosis is confirmed with
another supportive test.
12. DIAGNOSIS OF CEREBRAL
DEATH-2012
(1)The preconditions required in the diagnosis of
cerebral death
a)Specify of the reason of coma
b)Specify of that the brain damage is extensive and
irreversible
c)Central body tempereture be ≥32 C
d)No existence of Hypotansive shock chart
e)Ostracising the medicine affects and intoxications
that can provide irreversing from coma
f)No existence of metabolic , electrolit and acid-base
disorders that will explain the case independently from
the brain damage
13. DIAGNOSIS OF CEREBRAL
DEATH-2012
(2) On the condition that all the conditions are detected in the first
paragraph, following points are required for the cerebral death.
A)Deep coma state ( fully responselessness state)
B)Not receiving the brain stem reflexes
1)no pupilla response to the bright light ,central lined
and dilated
2) Absence of oculacephalic and vestibula-ocular
reflexes
3)Absence of cornea reflexes
4) Absence of pharyngeal and tracheal reflexes
C) No existence of spontenous aspiration effort and
positive apnea test.
14. DIAGNOSIS OF CEREBRAL
DEATH-2012
(3 ) Normothermia, normotension and normovolemia
preconditions are provided for running an apnea test.It should be
provided that PaCO2 be 35-45 mmHg and PaO2 be over 200
mmHg with the modality of suitable mechanic ventilation under
these circumstances.After providing all these conditions, patient
should be detached from mechanical aspiratory support unit and
intratracheal oxigen should be applied.If there is no spontenous
aspiration at the end of the test in spite of the fact that the PaCO2
≥60 and/or PaCO2 base value rises 20 mmHg or more , apnea
test is positive.
(4) In medical situations such as
pneumothorax,pneumomediastinum when apnea test is not
possible, a supportive test evaluating the arrest in brain
circulation determined by the board of doctors is run and cerebral
death detection is completed if the test result matches the
cerebral death diagnosis.
15. DIAGNOSIS OF CEREBRAL
DEATH-2012
(5) The following findings do not constitute an
impediment for the diagnosis of cerebral
death.
a) Reception of deep tendon reflexes
b)Reception of shallow reflexes
c) Presence of Babisnki sign
d)Presence of spinal reflexes and
automatisms
e)Presence of perspiration , reddening , high
temperature and tachycardia
f)No existence of Diabetes insipidus,
16. DIAGNOSIS OF CEREBRAL
DEATH-2012
(6) In cases diagnosed with cerebral death ;
a)The clinical view in the first neurologic examination when the
patient is diagnosed should continue without change in the
second neurologic examination performed after
48 hours for Newborns(younger than 2 months old)
24 hours for ages 2 months old – 1 year old
12 hours for children over 1 year old and adults
24 hours for anoxic cerebral death
b) In cases diagnosed with clinical celebral death , cerebral death
diagnosis is confirmed with 2 supportive test in the new born
(younger than 2 months old) group , with one laboratory
procedure accepted by the board of doctors in the cases who are
2 months old and over.
c) There is no need to wait for the second neurological
examination if a brain circulation evaluation test is run and the
results of the tests are positive for those who were clinically
diagnosed with cerebral death.
17. Diagnostic Criterias Supportive tests
Tests showing that
the brain circulation
is fully arrested
Transcranial Doppler
Cerebnal
Angiography
*Cerebnal Perfusion
Scintigraphy
Tests showing the
loss of bioelectrical
activity
*EEG
*Alerted Potentials
22. Attention !!!!
It is obliged that the group of doctors to
diagnose the cerebral death be totally
different from the team performing the
transplantation.
23. CEREBRAL DEATH and PATIENT
RELATIVE
*The state of patient’s heart continues
beating after the diagnosis of cerebral
death or brain stem death affects the
patient relative but ;
*If the brain stem dies, brain doesn’t
function and heart functions stops in a
short
24. AFFECT THE DECISION OF
ORGAN DONATION
Patient Relatives may develop such thoughts
and feelings as ;
Not enough care to their patients
Monetary gain
Organ trading
Disintegration of body
Anger
As a result of this ,
*They may not trust the hospital.
25. Transplantasyon Ekibine Güven
Katılıyorum
Fikrim
Yok
Katılmıyorum
Türkiye’de Doktorlar Beyin Ölümü
Kararını Doğru Verecek Durumdadır
%63,2 %27,6 %9,2
Organlarımı Bağışlarsam Tedavim
Yeterince Yapılmadan veya Tam Ölüm
Gerçekleşmeden Organlarım Alınabilir
%19,8 %28,2 %52,0
Organlarımı Bağışlarsam, Onlar Uygun
Şekilde Kullanılmaz ve Başka Bir İnsana
Fayda Sağlamaz. Yani Vücudum
Boşuna Kesilmiş Olur
%8,0 %25,2 %66,8
Organlarımı Bağışlarsam, Onlar
Gerçekten İhtiyacı Olanlara Değil Çok
Parası Olanlara Takılabilir
%24,8 %32,0 %43,2
26. REASONS OF DONOR ORGAN
LOSS
*Prolongation of diagnosis of cerebral
death
*prolongation of documantation
*prolongation of organ extraction
*Disorder in coordination (logistic)
*Physical transportation of organ to the
recipient ( Time Period)
27. ROLES OF INTENSIVE CARE UNIT
*Diagnosing the cerebral death in the shortest
time possible
*Sustaining the organ protective treatment
*Providing an accurate and healthy
communication between the donor’s family
and transplantation coordination center
*Intensive care is the one who treats patients,
not the one who requires donation
28. WHAT IS DONOR CARE?
*Donor care is the patient’s care after the
cerebral death
*It is a simultanous care of a few
recipient
29. MONİTORİZASYON
SÜREKLİ
• EKG,
• İnvaziv Arter
Basıncı
• SVB
• Pulsoksimetre
• Vücut Isısı
(mesane rektal
ozofajiyal)
SAATLİK
• İdrar
Çıkışı
HER 4-6 SAATTE BİR
• Kan Şekeri
• Na,CI,K
• Üre,Kreatin
• Hemogram
• Koagulasyon
Testleri
• Arterial
Kangazı
MONİTÖRİZASYON
33. COMMUNICATION WITH PATIENT
RELATIVES-1
*The patient family shoud be satisfied
with the care and attention to their
patients
*We should gain trust of patient relatives
through our body language and facial
expressions
*We should choose the most ideal family
relative to speak to
*We shouldn’t use medical terms.
34. COMMUNICATION WITH PATIENT
RELATIVES-2
We should give the patient’s relatives
adequate information about the care and
treatment
We should have a clear language about
the death time.
We should allow family to talk and
discharge
We should make them feel like a friend
35. COMMUNICATION WITH PATIENT
RELATIVES-3
We should provide the entrence of
relatives for the adoptation of family
We should let them take leave for the
last time in intensive care unit
We should listen to the family’s wishes
and requirements and answer their
questions
36. U-TURN
Aggressive
treatment
Deteriorising
state
Preparing the family
for the negative end
Legal diagnosis
Announcing the death and support to the
family
Life saving
transplantation
Supporting the donor
management
Discussing the donation
37. TRANSPLANTATION
*It is the changing procedure of
disfunctioning organ with an intact organ
(extracted from live or dead donor)
*Transplantation is the best option for the
treatment of End Term Organ Failure
patients
* It is applied in order to increase the life
quality and duration of patients
38. HISTORIC ASPECT
Cosmas and Damian
transplating a black
donor’s leg to a white
female
43. OUR CEREBRAL DEATH AND DONATION RATES
Year Cerebral Death
Medical
Contraindicati
on
Donation
Bağış oranı
2000 25 4 6 %24
2001 47 10 16 %43
2002 46 3 22 %49
2003 37 6 18 %61
2004 46 11 11 %34
2005 60 4 21 %34
44. Year Cerebral Death
Medical
Contraindicati
on
Donation
Bağış oranı
2006 35 7 10 %28
2007 17 1 5 %29
2008
4
0
2
%50
2009
16
2
4
%28
2010
21
0
11
%49
2011
23
1
4
%14
OUR CEREBRAL DEATH AND DONATION RATES
45. Year Cerebral Death Aile kabul Aile red
aile
görüşmeye
gelmedi
2011
2012
2013
2014
28
25
22
35
5
9
11
6
22
15
10
24
1
1
_
2
OUR CEREBRAL DEATH AND DONATION RATES
46. ORGAN DONATION AND NURSING
*Nurses should support the family from the
moment of informing the family of the cerebral
death to the moment of decision
*Intensive care nurses should be educated
and motivated in cerebral death and donor
care
*Positive effect has been stated in the results
with the rising information in organ donation
*Nurses shouldn’t forget that they maintain
many cares simultanously
47. CONCLUSION
It is important that we benefit from the
limited number of donations effectively
with respect to minimise the patient loss
Reports in the press affects the patient
relatives, thus the best press
communication method should be set up
It is extremely important that we know
the process of cerebral death and
monitoring
48. CONCLUSION
It is essential that we have experienced
personnel, high technology and
mechanical support for the nursing care
and treatments
Application of scheduled nursing
initiatives affects the prognosis of donor
positively and increases the quality of
organ
49. CONCLUSION
*When the patient dies in spite of all the
interventions, organ donation is a
positive result of a tragic situation.
Any word you say may make a
difference between a Yes or No.
