Withdrawal of Life Sustaining Measures Resources

The following resources and tools are meant to be adopted or adapted by hospitals, intensive care units, and organ donation organizations to support implementation of the Canadian Critical Care Society guideline for WLSM.

Implementation Tools

WLSM Checklist

The WLSM process is complex and made even more complex by the introduction of consent for donation after circulatory determination of death and the necessary preparation processes.  A checklist for the team to review prior to the process of WLSM was developed.

An additional section for donation after circulatory determination of death highlights those special considerations for DCD potential donors. Also see donation after circulatory determination of death for additional DCD resources.

English Version
French Version

WLSM Documentation Tool

A documentation tool that links symptoms, drug administration, and response to treatment was developed. 

English Version
French Version

WLSM Information for Families

Families and health care professionals reflected on the need for written documentation and tools to assist families in understanding the complexity of the actions that occur prior to, during, and after the WLSM.

The information leaflet assists families in receiving information in multiple formats when information is most difficult to absorb. Also see donation after circulatory determination of death for additional DCD resources for families.

English Version
French Version

WLSM Order Set

The order set exists as a clear plan for symptom management, developed and discussed in advance of apparent symptoms, so health-care professionals and families/substitute decision makers are clear on a plan. 

English Version
French Version

Quality Assurance Tools

WLSM Policy Template

While individual needs for a policy framework will vary from hospital to hospital, it is often helpful to begin with a common structure and tailor the specific policy to meet the needs and interests at the hospital.  This policy framework provides minimum specifications to implement the Canadian Critical Care Society’s WLSM guideline effectively. 

English Version
French Version

WLSM Case Audit Tool

Organ donation committees, ICU councils, or intensivists may wish to audit a series of WLSM cases in a random or systematic sampling after the WLSM guideline has been implemented.

This tool, to be used on a case by case basis, evaluates adherence to components of the WLSM guideline recommendations. Cumulative analysis of a series of cases of WLSM may identify opportunities for process improvement within the hospital.

English Version
French Version

WLSM System Audit Tool

It is necessary to understand and measure whether the WLSM guideline has been implemented in various hospital systems.  This is of interest to hospitals and organ donation organizations who support DCD processes.

This resource is a list of recommended requirements at a hospital level that would be put into place, in advance of cases of WLSM, to support professionals and families in the process, as determined by the guideline. 

This tool could be used by the organ donation organizations to engage in communication with the hospital stakeholders around quality management in this regard.

English Version
French Version

Guiding principles for implementation of the WLSM guideline in DCD practice are available here.