No Mistakes with ECMO

Five Minute Teaching 001

Extracorporeal Membrane Oxygenation (ECMO) is an exciting therapy for critically ill patients. Like all interventions, unfortunately, there is the risk of causing more harm than help!!

We spend a lot of time at the Alfred making sure we minimise the risk of complications and have come up with a mnemonic (what is ICU without mnemonics!)

At least it is easy to remember:

ECMO

  • Electrical safety
  • Cannula care
  • Movement of ECMO patients
  • Operation or procedures on ECMO patients

ELECTRICAL SAFETY

Do not allow water to enter any ECMO drive unit.

The Rotaflow pump should always face up to prevent water entering in the event of a spill.

Nothing that could leak should ever be placed above a pump.

CANNULA CARE

Secure the cannulae at two points (we use grip locks).

Nursing staff should check position of the cannulas each shift and medical staff should check them on every ward round (including on any CXR performed).

Check the cannula dressing is unsoiled each shift.

MOVEMENT OF ECMO PATIENTS

Always have a designated staff member to watch the lines.

Only ECMO accredited staff to manage the console.

If transporting within the hospital there must be two ECMO accredited staff with the patient at all times.

OPERATION OR PROCEDURES ON ECMO PATIENTS

Minimise procedures performed on ECMO patients due to the increased risk of complications especially bleeding.

We also avoid insertion of intercostal catheters unless there are signs of mediastinal tension.

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