Univ of Mich ECMO training

In my hospital we also utilize RN's in the PICU and NICU as ECMO specialists and primers. I have done ECMO for about 3 years now and find it very fun and interesting, especially as a primer.

Unfortunatley, our number of ECMO patients has been decreasing every year, with a lot of near misses. So it can be difficult to stay on your "game" and be prepared.

We've had some "miscommunications" too, and have had some hairy incidents. One involved a stopcock turned the wrong way while the dead-ender was off, causing a huge volume of air being entrained. The nurse had just come back from a six-month sick leave and was the only ECLS person scheduled, so she was put in the room cold. Another involved a cracked connector, once again causing a large volume of air to be sucked into the circuit. Both of these kids were on for respiratory reasons and the problem was noticed in time for the specialist to clamp off the cannula, so the ensuing mayhem was mitigated by the fact that they'd survive the interruption. A third horrible event happened in the OR on a cardiac case; a perfusionist-in-training connected the cannulas backwards and the kid did get a big embolus of air. I seem to recall the kid survived... albeit badly damaged.

Providing ECLS is a huge responsibility. Stable runs can be brain-numbingly routine, but you have to be prepared for anything and everything. I'm considering taking a spot on the team, but haven't made up my mind yet whether I want the stress! Our use of ECLS is increasing all the time and maintaining skills wouldn't be a problem!

hey there,

i sent you a PM earlier, actually yesterday, and hadnt seen this post. it seems you and I received a response at around the same time (11-15-07 around 815am from the admin assistant).

i felt the same way about the course. it seems WAY TOO short. for the price tag i would want something around 8-16wks of distance education and then perhaps a week long "in-house" final competency check off and exam.

Philly doesnt really attract me, but CHOP is world renowned... CHOP recruits nursing and respiratory students here at my school and actually pays us to go visit. i hear that their PICU is a little different from the norm. look up an article titled "Care Teams of Respiratory Therapists and Nurses in a PICU Setting by Schultz and Napoli", you may find it interesting.

to other ECMO Specialists, what is the average length of in-house didactic training that you received? (not including hours w/ a preceptor)

also, anybody here work at or have experience with the ECMO programs at Childrens at Dallas or Egleston/CHOA in Atlanta?

I know this is a bit off topic, but since we are mentioning CHOP...

All i have to say is that its too bad they pay their nurses peanuts. i was quite surprised with how little they pay their nurses, considering how specialized these hospitals are, and how well trained their nurses need to be. Boston Children's is the same way. And its definitely not the "difference in cost of living"...

Egleston trains RN's and RT's in house. Once you have proven yourself you can apply. If accepted there are classes and you have several shifts where you sit the pump with a preceptor. Each of the ICU's (PICU, NICU, CICU) have specialists on staff. The schedules are made as regular working schedules with people designated as 1st, 2nd, or 3rd ECMO. If there are no pumps running you work your regular shift. If there are more that 3 running they will call in extra specialists as needed. ECMO cases are 2:1, the pt has a nurse and the pump has a specialist but I have heard that in NICU stable runs will have a nurse with another pt.

I started doing ECMO in 1991. I had 5 years of adult ICU experience and 1 year of NICU experience. I moved to the combined PICU/CICU in 1993 and continued to do ECMO until 2001 when I took a management position. I started to do ECMO again almost two years ago when I left management. It is a huge responsibility. You must make sure you feel adequately educated and trained. Your patient can die in seconds if something goes wrong...and if you do it long enough, something will. You have to be ready to act autonomously and in an instant, because in most centers, there is not a perfusionist at the bedside. That being said, ECMO allows you to use your nursing skills to the fullest. It can be very rewarding and very sad. You become very close to the parent's of the kids. Make sure you are sure you want to do this. I suggest you spend a shift with an ECMO patient and really question the ECMO specialist about the responsibilities, training and ongoing education in your institution.

4 days is simply not enough time. I'm sure their own employees receive more time. The Children's Hospital where I did my ECMO circuit training gave us 5 days "classroom" time with circuit to play with so that we could talk about troubleshooting, ect. Mind you, we were all bedside ECMO nurses already. Then we got 6 shifts on the pump with a preceptor(RT or RN) Then we had to practice priming- most nervewracking part- and we were required to do 3 primes independently with a preceptor before we could do it on our own.
My advise, $2000 is alot of money and I think you might come out of the class feeling knowledgable but not quite confident in priming. IMHO you need to feel very confident!
Good luck to you...... keep us posted on what you decide.