Hi, my wife is a transplant nurse and I asked her your question, she agrees with Amy, she said the only sure sign she has seen is when a person turns orange, you hit orange and the train is close to the station.
Pleas egive your stepdaugter an extra hug for me, that poor young lady, she will need lots of help trying to apcka all that guilt around.
If there is any way you can make it happen, I think getting her involved in ala-teen would be very good for her.
Best of luck,
Bill