Andrew Healey takes us on an exploration of the early phases of donor management in ICU and Emergency Medicine in his heart felt SMACC Chicago talk Optimizing the Care of the Organ Donation Patient. Which focuses on the processes of managing donor patients and their families,  while they ride their ICU/ ED journey through to organ donor.    Healey summarises his talk into four main points:   1. Set families up to make the right decisions -  be it with end of life care or organ donation.   2. Preserve the opportunity for donation - understand that this is often the last decisions a family will have to make about a loved one and they may need time.    3. Never Say No -  never say no to an organ donation, ask the specialist. The only people who can decide if a person is not ideal for organ donation are those people who intimately know the recipient.  Healey sights some interesting stats that are worth thinking about such as;   1 out of every 4 people who are on the heart transplant list in Canada die. While, the risk of contracting HIV or Hepatitis from a transplant heart is 1 in 4000 (HIV) and 1 in 245 (hepatitis). With these in mind the elevated risk donor can look less risky.    4. Remember Organ Donation is never merely a mention - It's up to physicians and critical care providers to guide families to make the right decisions.