I Didn’t Like The Idea Then

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And I don’t like it any more now. I wrote about this idea over two years ago, when this blog was pretty new. Like most bad ideas, it just won’t go away.

City to Deploy Ambulances to Save Organs

Some 911 calls in Manhattan will now bring out two ambulances, one hurrying to the scene and one lagging slightly behind.

The first one will try to save the patient’s life. The second one will try to save the patient’s kidneys, in case the first ambulance fails.

I think the idea is bad for EMS, which means that it will at some point be bad for patients. Whenever the liberals don’t like a proposal, they talk about how it will have a “chilling” effect on potential users of a government service. I think that some people are going to be confused by this program and will be more hesitant to call 9-1-1 if they need an ambulance. It’s bad enough that some morons already call ambulances “meat wagons” without going ahead and making them right.

To overcome fears that patients would be allowed to die for the sake of their organs, officials said that doctors and paramedics trying to resuscitate a patient would not be told whether the preservation unit was waiting in the wings until a supervisor had given the order to stop rescue efforts. The organ team, which will travel in a bright red and white ambulance marked “Organ Preservation Unit,” is supposed to remain out of sight.

For those of you not familiar with New York City, here is what a city ambulance looks like,

You’ll notice that it’s bright red and white and marked “Ambulance” as opposed to “Organ Preservation Unit”. Other than that, I wonder how much different the OPUs will be?

I’m working on the assumption here that the staff of this unit would not be removing organs on scene, but would be transporting the deceased person to a hospital where harvesting would take place. Seems a bit odd to me to have an ambulance rushing a dead person to a hospital when for the past several years many EMS systems (and NYC was among the first) have taken not transporting the obviously dead because of the added risk of lights and siren transport.

It will be no surprise to many of my readers to find that, like so many bad ideas, this one is being financed with a $1.5 million federal grant.

As I said in my original post, I’m not against organ donation although I think that the ultimate solution will come from regenerating or growing organs from stem cells. I am against anything that confuses the public about the role of EMS and I think that this sort of thing will do exactly that.

13 COMMENTS

  1. TOTWTYTR,
    It’s not clear what the vehicles will be or if they’re actually in service. As is clear from the private ambulance behind the municipal one in the picture there are probably close to 40 ambulance designs and liveries currently in use in NYC. Ambulances in NY are mandated to say Ambulance in large letters on 3 sides as is, and paint schemes must be approved by the Department of Health. FDNY has a fair number of ambulances not used as EMS vehicles with the exact same paint scheme but no SOL (except for the “Training Units” at the academy, weirded me out the first time I saw one on the LIE). I’m a fan of organ donation but there’s very little of it going on. I understand the desire to bring in donors from the field to be worked up but not sure how it will work out. This should be a very limited trial for now, if I hear anything from the street I’ll be back to check in. Stay safe!
    -bill

    • Actually Murph, it’s an old E-350 Ambulance in the FDNY paint scheme with the words “Organ Preservation Unit” in 3-inch high red lettering on three sides, which is what DOH requires. Rumor has it the truck is actually from the Cumberland substation where they just got three new lances.

      The NY Post had a photo of it.

      The REAL question is how much does the hospital stand to make on a transplant?

  2. Will these be exclusive to those only with donor cards? And is the OPU going to be staffed with who? A nurse a surgeon and a driver? Or are they going to let basics// medics perform surgery in the field?

  3. Having read some more articles about it recently, I have grown a little more accepting of this program. It seems as if cardiac arrest would be the chief call type to get this service sent to it. As a medic, I would hope that medics don’t “slow code” in order to make this program work. On the other hand, if a patient is pronounced after all efforts to resuscitate have been exhausted, this is the best chance to harvest those organs, especially if the patient is a donor. Otherwise, those organs would be lost forever.

    The one worry I have is that the quoted article above says that resuscitation will be stopped on a supervisor’s orders. I hope this is not a change in the current system in which the paramedic and telemetry determine when to stop, especially since there are several BLS supervisors. I, for one, will not adjust my patient care at the direction of a lower trained provider and will not stop without exhausting all efforts and telemetry consultation.

    Drew

  4. Those who fail to study the future (science fiction) are doomed to repeat it.

    This is right out of Larry Niven’s “The Long Arm of Gil Hamilton”. Totally delves into legal and illegal harvesting of organs for transplanting, until scientists develop the capability of growing organs from scratch.

    Spooky!

  5. Our current organ donation system is perfectly designed to get the results we’re getting now: 17 people die each day waiting for a transplantable organ. This program may increase the number of organs available for transplant. It may not. Without trying, we won’t know. As for the money, we both know that’s little more than treasury pocket lint. This may go some way towards proving that this type of system can work (though, as I’ve said before, I suspect Manhattan isn’t a place where it will). Once we identify that the system *can* work, then we can figure out ways to make it more cost-effective.

  6. As much as I would like to see more organ donation going on, I don’t like this idea either.

    With pregnant women who are probably dead but still have a viable fetus, we’re taught to continue CPR until we get to the hosptial until we get the recieving facility. Shouldn’t we be employing a similar program for organ recovery? (I’m sorry if someone doesn’t like this comparison, as some feel an unborn child is completely different than a human organ.

    I thought organ harvesting need to occur in a sterile surgical facility with a team of doctors and nurses, and not by a couple of medics in the back of a bouncing rig?

    • At the risk of sounding anti transplant, I don’t like the idea of transporting someone just to preserve their organs for harvesting. L&S transport is dangerous, and I’m constantly telling BLS crews to slow down when we’re on the way to the hospital. I didn’t get the sense that the harvesting would occur in the field, but maybe I”m wrong. If it is, then I think you’re right. Since I consider a viable fetus an organism, not an organ, I agree with you on that. If it seems that the fetus is viable, then it’s reasonable to transport the mother. Keep in mind that maternal death almost always results in fetal death. Yes, I know there are exceptions, but they are actually few and far between.

    • And there’s really no way to keep the rig sterilized once u open the doors :bam: no longer sterilized. Then honestly what happens when u figure out a way to bypass those obvious problems. What about when u crack open a chest (still assuming ur in the field) and start ripping out lungs that are charred black. A heart that’s all gunked full of shit. Kidneys, liver, anything u could have harvested shot. And u just wasted ur time and resources harvesting the organs on a IV drug using STD ridden individual. After the first couple hundred the govn’t is going to get tired of wasting the money on their new specialized services. I don’t know guys. I’m pro donor. And I’m pro THEORETIC OPU. but there are way to many flaws and shit I doubt the states aren’t considering.

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