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ECMO : In Hospital and Transport
Rating: 4.3 out of 5(22 ratings)
131 students

ECMO : In Hospital and Transport

What can go wrong, will, at the worse possible time
Created byJennifer Vieira
Last updated 10/2022
English
English [Auto],

What you'll learn

  • Define ECMO and understand the purpose
  • Understand the separate circulation physiology between the patient and mechanical unit
  • Understand the most common emergencies with an ECMO patient
  • Understand interventions for the most common emergencies

Course content

3 sections • 28 lectures • 1h 41m total length

  • Introduction1:53

    Many learners that opt to take this course will have some level of understanding of ECMO.  However, now that ECMO is becoming an highly utilized intervention and it being implemented in community hospitals, the health care industry needs nurses and paramedics to be trained well with the management of the system.  This includes the need for these professionals to be able to transport the patient on the system in a safe manner to a tertiary center.  Because of the complexities of the system, it can be overwhelming to start from the beginning.  This course will provide the most serious complications that can occur and what to do acutely to manage it. 

  • Objectives0:36

    Clarify that objectives do not cover ECMO standard of care, given variations by HMO teams and initiation rationale, and describe ECMO numbers, values, and management of common and serious complications.

  • WHAT IS ECMO10:05
  • WHY VA ECMO2:24

    Compare vv ECMO and VA ECMO to explain why vv is preferred for respiratory failure. Highlight venous access benefits, reduced arterial risks, avoidance of differential hypoxia, and improved lung oxygenation.

  • ACCESS SITES/LINES2:40
  • Different Types1:59
  • Transport Specifics7:45

    Master ECMO transport logistics by assigning cannula management to a specialist, performing a pre-move timeout, rechecking cannula sites and circuit, and ensuring securement and power readiness during transport.

  • Pump Physiology8:34

    Explore how the ECMO pump drives blood flow and sweep gas to oxygenate blood and remove carbon dioxide, linking RPMs, flow, and ventilation to preload and afterload.

  • Patient Physiology3:11

    Evaluate patient physiology on ECMO by interpreting negative pressure (venous) and positive pressure (afterload) values to troubleshoot preload and afterload issues, and track trends to prevent harm.

  • Lecture 10 with Quiz1:04

    Review a quick ECMO quiz on post-oxygenator CO2 management. Learn to increase sweep gas flow to boost diffusion and blow off CO2, mirroring ventilator adjustments.

Requirements

  • Critical Care Nursing, paramedics, respiratory therapy, perfusionists, transport technicians

Description

This course walks the student through the basic physiology of the ECMO system.  In addition, it teaches about the most common emergencies and how to intervene with limited resources, especially in transport.  Students that would benefit from this course in any critical care nurse, paramedic, or physician. 

Extracorporeal membrane oxygenation (ECMO), a term used to describe oxygenation that occurs outside of the body, is an increasingly common means of supporting the most critically ill patients. Because of the invasiveness and high probability of serious complications during ECMO, it is typically indicated only when there is a high likelihood of death with conventional treatment. With continued improvements in technology and increasing clinical experience, transport clinicians are increasingly likely to be called on to care for ECMO patients. 

Highlights include:

  • Critical care transport clinicians must appreciate the differences between venovenous and venoarterial extracorporeal membrane oxygenation (ECMO) as well as common indications for each and the physiology of both configurations

  • Traditional monitoring techniques such as peripheral capillary oxygen saturation may not be reliable

  • Preparation for emergencies is imperative because decompensation can be rapid and masked until death occurs

  • ECMO is a bridge to another option and is not a cure

  • Critical Care Providers must know if a patient is a candidate for ECMO support prior to making the decision


Who this course is for:

  • Intermediate critical care nurses, paramedics, transport technicians, resident doctors, respiratory therapists

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