Introduction: Emergency life-saving technicians (ELSTs), who are certified specialists trained for prehospital emergency care in Japan, are the principal decision maker to provide medical care to severely neurologically damaged patients. The aim of this study is to clarify awareness of ELSTs toward organ donation and their feasibility of confirming emergency patients’ declaration cards regarding organ donation on site.
Method: A 39-question survey was distributed through Google Forms to ELSTs of fire department (FD) and medical staff of emergency medical centers (EMC) in Tokyo and Osaka in 2024. It consisted of various sections aiming to evaluate differences among three occupations in awareness toward organ donation and ELSTs feasibility of confirming emergency patients’ declaration cards regarding organ donation on site. Respondents' anonymity was ensured.
Results: Due to the Tokyo FD’s policy, no ELSTs in Tokyo responded. 192 ELSTs of FD and 89 medical staff of EMC (36 physicians and 53 nurses) in Osaka responded to the questionnaire for a 21.0 and 6.1 % response rate, respectively. Although the possession rate of their own declaration cards regarding organ donation in ELSTs (63.5%) was significantly higher than that in physicians and nurses of EMC (both 50.0%), their interest rate in organ donation (62.0%) was significantly lower that of physicians and nurses of EMC (94.4 and 84.9%, respectively). Compared to the medical staff of EMC, fewer ELSTs had experience receiving lectures or training on organ donation, showed desire to receive such training and were aware that the organ donor card includes an option to refuse organ donation. Moreover, fewer ELSTs had discussed organ donation with family members or knew that organ donation could proceed with family consent.
Regarding the ELSTs’ feasibility of confirming for declaration cards regarding organ donation at emergency scenes, 13.5% answered “possible” and 53.6% answered “possible if there is enough time”, totaling 67.1% who considered it feasible. 32.6% of ELSTs had experience of finding declaration cards regarding organ donation at emergency scenes. The only factor significantly associated with the feasibility of confirming declaration card regarding organ donation at emergency scenes was the rate of experience of finding declaration card regarding organ donation at emergency scenes (p = 0.042).
Conclusion: Although the possession rate of their declaration card regarding organ donation in ELSTs was greater than the medical staff of EMC, the interest rate in organ donation of ELSTs was lower than the medical staff of EMC, probably because they had little opportunities to learn organ donation before and after becoming ELSTs. To improve their awareness and attitude towards organ donation, we need to establish education programs of organ donation for ELSTs and increase the opportunity for them to learn organ donation. And their experience finding declaration cards regarding organ donation at emergency scenes may increase the likelihood of confirming them in emergency situations.