lily0004us

Just curious Calla, how many ECMO circuits do you guys have? I assume you always keep one on standby. When we have four kids on, staffing becomes a nightmare! Nine kids on ECMO in one week, Wow! When we get a CDH baby, we always think we will get two more....and it seems like it happens! Also, we have a certain Attending who, when on service, attracts major Congenital heart defects like a magnet.

Our policy is to prep the port with betadine or persist (betadine/alcohol swab). It's important to let the betadine dry so I usually prep first and then gather my supplies. I clear the line with approximately 1 cc (for an ABG ... more for a chemistry or coags). After drawing the gas, and making sure I have not contaminated the clear, I give it back. I then clean the blood off the port with alcohol. Some nurses draw back less and waste the clear, but I prefer to do it this way because a heparin- contaminated gas is useless. If you're ever surprised by an incredibly acidotic gas result with PCo2 in the teens and a significant base deficit, it may be heparin-contaminated.

What a great idea. (Filling the TB syringe with the sliver) I've been in the NICU several years and I still learn something new everyday!

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