So, now you’re an ECMO SPECIALIST! Fresh out of training at a newly established ECMO Center. All nine pages of the ELSO GUIDELINES for TRAINING ECMO Specialists have been faithfully followed. The initial training, simulation, and precepting has been completed. But that nagging fear about your own readiness for the responsibility of “flying alone” won’t go away.
Begin with the self-reminder that you are not alone. You have access to expert opinions. And remember that many ECMO issues are time sensitive but not always truly emergent. You’ll generally have the opportunity to review policy, refer to your training manual and notes, or call the ECMO Coordinator/Perfusionist/Physician/ECMO Director,etc.
Next, self-assess your readiness by answering the following questions.
Can you manage the worst case emergencies?
- Protect the patient by isolating from the ECMO circuit
- Recognize and eliminate air (and stop the source).
- Respond appropriately to blood spurting from the circuit or cannula site(s).
- Recognize and repair/replace failed equipment or components (hand cranking if necessary).
Can you recognize and respond to decreased venous return?
Can you recognize and respond to recirculation on VV ECMO?
As a new ECMO Specialist you should have gained the confidence in both comprehension and planned response to these events during ECMO training. Greater comfort at the bedside will only be gained with time and experience, but at a minimum the new ECMO Specialist absolutely needs to have practiced and memorized this core knowledge. If you find you can’t answer these questions with an unqualified “yes!”, then seek out additional education and/or simulation training. When all answers are positive, then as a new ECMO Specialist you are ready to sit alone.
Congratulations on your new beginning as an ECMO Specialist!!
Authored by Richard Toney, RN, ECMO Advantage Specialist
ECMO Advantage offers training and simulation experiences for ECMO Teams to help them be prepared and feel comfortable in their ability to care for ECMO patients. Please contact us to learn more.