Who runs your ECMO pumps?

[elizabells]

Hey, all. In the time I've worked in the NICU, I've gotten hopelessly, irredeemably addicted to ECMO. At my hospital Clinical Perfusionists set up and run the pumps and we look after the babies. I know there are hospitals out there that have RNs on pump after it's set up. Anyone work at one? I'm prepared to go to perfusion school if I must, but the prospect of going back to college for yet a third time is a little daunting.

[lovemyjob]

Medical College of Ga Childrens medical center has only RN's and RRT's running the pump. The nurses, who are the primary ones who run our pumps, all have 10+ years of experience. They are also our transport clinicians. The nurses and RRTs who run our pumps all have had extensive training.

[Tomskatt]

Our ECMO team is made up of mostly RNs and some RTs. Experience and training necessary. I am at CMC, Charlotte, NC.

[dilleweed]

Le Bonheur in Memphis uses both RN's and RT's to run ECMO. I don't know if they got their specialized training locally or elsewhere.

[RNCFinally]

I used to work at a hospital in Queens NY. The perfusinist would set it up and the NICU and PICU nurses would run the pump... I am sure this was much more cost effective than paying a perfusionist... :) But It was great experience!! Both the patient and pump nurse were ECMO trained

[NotReady4PrimeTime, RN]

At the Stollery Children's Hospital in Edmonton, Alberta, Canada, the pump is run by either an RN or RRT. The numbers of each on the team are roughly equal. They require a minimum of two years' critical care experience and the recommendation of other team members, undergo advanced training to learn all the ins and outs (pardon the pun) and then have a 120 hour preceptorship. The ECMO team is based in PICU and have done runs on kids as young as hours old, all the way up to older teenagers. Because the Stollery is the base for the Western Canadian Children's Heart Network, most of their runs are V-A, although there have been a significant number of V-V runs recently. They have space and resources for four patients at a time. They also provide mobile ECMO, travelling to centers that don't offer ECMO to cannulate and transport patients back to their center. Their first two transports were children who had already been cannulated by an enterprising interventional cardiologist and a trauma surgeon (they used a 14 Fr chest tube on one patient due to the unavailability of an appropriately sized cannula); the pump was run in the interim by a perfusionist from the adult CV service. The Stollery is also the North American training center for the Berlin heart, as shown on the child in the photo on the right:

http://www.picu.med.ualberta.ca/ecls.html

[NurseKerry]

Primary Children's Medical Center In SLC, Utah.

We have a nursing based ECMO team. The NICU and PICU nurses run the whole show. We have an amazing Attending that helps with oversee but it is a truly nursing based program. All of the training is done in-house. Through the NICU there is a significant amount of education and testing to be passed to get to be able to apply for the ECMO module but you can fast track it if you are willing to put in the effort. I am not sure how the PICU does it.

[chare]

Nationwide Children's in Columbus OH used to use both RN's and RT's to run the pump after cannulization and initial setup, however I've been gone several years so this might have changed.

Hope this information was helpful.

[dawnebeth]

We have specially trained ECMO nurses at Oakland Children's--in fact, they not only do the pump in the nursery but also in the PICU, since ICU never trained any of their own nurses for the pump. One nurse for the baby, one nurse for the pump.

Dawn

[NeoNurseTX, RN]

We have specially trained RNs and RTs to run them; mostly RNs. I'm at Children's Memorial Hermann in Houston, TX.

[BabyRN2Be]

For our team there are two purposes to mobile ECMO:

1) If we receive a referring call for a patient who is too unstable for conventional transport it allows our team to go to the referring hospital, cannulate there, then transport the patient on ECMO back to our facility.

2) In addition we serve as a backup suport system to address medical needs that may exceed the resources of outreach institutions. We are able to support I believe up to six patients at a time on ECMO while many facilities close to us can only support one to two at a time.

Thanks for the great question!

As an aviation person, I've got to know this... do you transport via helicopter or fixed-wing aircraft?

[meandragonbrett]

Lebonheur Children's Hospital in Memphis, TN has RNs that run ECMO

[NotReady4PrimeTime, RN]

As an aviation person, I've got to know this... do you transport via helicopter or fixed-wing aircraft?

Our ECLS transport team flies fixed-wing. Our first transport (years ago now) was cobbled together over a holiday weekend; we needed to use a military Hercules for the stretcher and equipment for that one. Now our drivers are more portable and we can use a standard air ambulance, but there's still no way it would all fit into our medevac helos.