ECMO Management for Specialists – Questions
With Thorough Solutions
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Terms in this set (81)
Pros: Experts on ECMO circuit flow dynamics and
advanced trouble shooting
ECMO Staffing model -
Perfusion model
Cons: Lacks patient care knowledge and understanding
of ICU concepts
Pros: Experts on acute patient care and advanced ICU
concepts
ECMO Staffing model -
ECMO Specialist model
Cons: Lacks Experience with ECMO advanced trouble
shooting
maintains integrity of the ECMO circuit
Titrate ECMO
-Flows
-Sweep
Role of the ECMO -FdO2
Specialist
monitor for ECMO complications
intervenes during ECMO emergencies
Assists with 'day to day' patient clinical decision making
role of bedside nurse assessment, monitoring, and documentation
, DO NOT LEAVE THE ROOM
Responsible for:
-IVP Medications
Roles during ECMO -Titration of drips
bedside insertion - Bedside -Vent
RN -Defibrillation/ACLS
Speaking with MDS/NPs
Delegation
Obtaining the insertion cart
Builds and primes ECMO CIRCUIT
Roles during ECMO Assisting MDs with cannula placement
bedside insertion - ECMO
Specialist Hands off ECMO lines
Notifying Bedside RN when to give Heparin and dose
Initiates ECMO therapy
Prep well
-OR style not ICU style
-Cannula infections are devastating
Full body drape
Prep and drape
-Wires are long and can get contaminated easy
-use femoral drape (Cath lab, Blue towels, ect.)
Use bedside table under drape at the foot of the bed
-Open all sterile kits before beginning procedure
, encourage use of ultrasound
-Easier to identify correct vessel
-Can also confirm cannula is correct place
use Pik-A and Pik-V kits for initial access
Vascular Access
use micropuncture kit for distal perfusion catheter
access
two or more person procedure
Observe for good "wire skills"
-Keep the wire straight a all times (two person job)
-floss the wire (move it back and forth)
-Do not kink the wire
-may need a super stiff or Amplatz wire
Serial Dilation Adequate Dilation
-advance and rotate freely
-multiple passes
Minimize potential for bleeding
- Enlarge skin incision as you go (Avoid excessive
dissection)
Should be easy if proper dilated
do not allow cannula and dilator to "uncouple"
place at correct depth
Placement of cannula - Err on the side of placing femoral cannula too deep
- can estimate by measuring from insertion sire to
xiphoid
Flush cannula periodically if there are delays on placing
cannula
With Thorough Solutions
Save
Terms in this set (81)
Pros: Experts on ECMO circuit flow dynamics and
advanced trouble shooting
ECMO Staffing model -
Perfusion model
Cons: Lacks patient care knowledge and understanding
of ICU concepts
Pros: Experts on acute patient care and advanced ICU
concepts
ECMO Staffing model -
ECMO Specialist model
Cons: Lacks Experience with ECMO advanced trouble
shooting
maintains integrity of the ECMO circuit
Titrate ECMO
-Flows
-Sweep
Role of the ECMO -FdO2
Specialist
monitor for ECMO complications
intervenes during ECMO emergencies
Assists with 'day to day' patient clinical decision making
role of bedside nurse assessment, monitoring, and documentation
, DO NOT LEAVE THE ROOM
Responsible for:
-IVP Medications
Roles during ECMO -Titration of drips
bedside insertion - Bedside -Vent
RN -Defibrillation/ACLS
Speaking with MDS/NPs
Delegation
Obtaining the insertion cart
Builds and primes ECMO CIRCUIT
Roles during ECMO Assisting MDs with cannula placement
bedside insertion - ECMO
Specialist Hands off ECMO lines
Notifying Bedside RN when to give Heparin and dose
Initiates ECMO therapy
Prep well
-OR style not ICU style
-Cannula infections are devastating
Full body drape
Prep and drape
-Wires are long and can get contaminated easy
-use femoral drape (Cath lab, Blue towels, ect.)
Use bedside table under drape at the foot of the bed
-Open all sterile kits before beginning procedure
, encourage use of ultrasound
-Easier to identify correct vessel
-Can also confirm cannula is correct place
use Pik-A and Pik-V kits for initial access
Vascular Access
use micropuncture kit for distal perfusion catheter
access
two or more person procedure
Observe for good "wire skills"
-Keep the wire straight a all times (two person job)
-floss the wire (move it back and forth)
-Do not kink the wire
-may need a super stiff or Amplatz wire
Serial Dilation Adequate Dilation
-advance and rotate freely
-multiple passes
Minimize potential for bleeding
- Enlarge skin incision as you go (Avoid excessive
dissection)
Should be easy if proper dilated
do not allow cannula and dilator to "uncouple"
place at correct depth
Placement of cannula - Err on the side of placing femoral cannula too deep
- can estimate by measuring from insertion sire to
xiphoid
Flush cannula periodically if there are delays on placing
cannula
