Physiotherapy in Patients on the Organ Donation Pathway: A Survey of Current Practice

Background. The purpose of the survey was to identify the current practices of physiothera-pists in the management of patients on the organ donation pathway. Methods. The author conducted a cross-sectional telephone survey. Participants were 16 phys-iotherapists working in intensive care units (ICU) in Queensland, who were involved in the care of patients on the organ donation pathway. Results. In Queensland ICUs, only 57% of hospitals have formal guidelines for physiotherapy management of patients on the organ donation pathway. When comparing the frequency of inter-ventions with organ donation status, 86% of physiotherapists reported increasing the frequency of interventions once a patient was considered for organ donation. Clinical reasoning was reported as the primary factor affecting intervention choice for 67% of physiotherapists, with no difference in frequency, or choice of intervention in patients for donation after circulatory death, compared with donation after brain death. In hospitals with a level I ICU (with infrequent expo -sure to organ donation), the use of protocols was supported by 100% of participants, whereas in hospitals with a level II and III ICU (and greater exposure), only 31% of participants supported the use of protocols. Conclusions. There are wide variations and a lack of formal guidelines for physiotherapy management of patients on the organ donation pathway; however, clinical reasoning appears to be favored above protocolized management in hospitals with level II and level III ICUs.