Do Paramedics Have a Role to Play in Organ Donation?
Notice bibliographique
Résumé
As readers are aware, many jurisdictions rely on paramedics to deliver ambulance services and 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 optimization 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 gray-area, with little to guide their actions. As such, 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.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,013 | 0,065 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,004 | 0,005 |
| Communication savante | 0,007 | 0,017 |
| Science ouverte | 0,002 | 0,005 |
| Intégrité de la recherche | 0,010 | 0,010 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,030 | 0,008 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».