ECMO Education for Nurses Outline

 

  • Perfusion Overview
    • Definition
    • What the machine actually does
    • Two Types of ECMO:
      • Veno-Arterial (VA)
      • Veno-Venous (VV
    • Indications and Contraindications
    • ECMO Circuit and Its Components
    • Types of Cannulation for VA and VV
  • Patient Selection
    • Outlining the Respiratory Failure Patient
    • Outlining the Cardiac Failure Patient
    • Making the Decision to Go On ECMO
  • Management of the ECMO Patient:
    • Receiving an ECMO Patient:
      • ICU Room Additions: Equipment
    • Establish a Treatment Plan
      • Treat underlying pathology or “rest” affected organs
      • Set Patient Parameters
    • How ECMO Affects Your Patient:
      • 2 Circulation Systems providing perfusion and oxygenation
      • Blood Circulation Changes
      • Blood Pressure
      • Pulse Ox
      • Fluid Balance
      • Blood Components
      • Anticoagulation Requirements:
      • Blood Gas and CBC Values 
  • Responsibilities of the Perfusionist
    • Circuit Preservation and Monitoring
    • Patient Observation
  • Nursing Care for the ECMO Patient
    • ECMO Considerations for the Patient:
      • ECMO Circuit and Lines
      • BP and Pulse Ox
      • ECMO and Ventilator settings
      • Assess Cannulation Sites
      • Monitor Anticoagulation
      • Assess Neuro and Renal Status
      • Assess Peripheral Perfusion
      • Sedation and Pain Control
      • Fluid Status
      • Blood Gas and CBC Analysis
      • Daily X-Ray and Echo
      • Infection Control and Wound Care
  • Treatment Plans for the ECMO Patient:
    • Veno-Arterial:
      • Rest and Regain Function
      • Bridge to VAD or Transplant
    • Veno-Venous:
      • Rest and Regain Function
      • Bridge to Transplant
    • Balance of ECMO and Ventilator Settings for Optimal Results
    • Fluid Balance and Management
    • Optimizing Perfusion for End-Organ Preservation
    • Assessing Improvement of Pulmonary and Cardiac Function
    • Weaning from VA ECMO
    • Weaning from VV ECMO
    • Decannulating the Patient
  • Withdrawal of ECMO Support
    • Ethical and social issues
    • Medical decision making process
    • Family Component 
  • Emergencies and Complications during ECMO:
    • Patient:
      • Cardiac Arrest
      • Hypovolemia/Hypotension
      • Hypoxia
      • Severe Coagulopathy
      • Severe Bleeding
      • Neurologic complications
      • End-organ failure
    • Mechanical:
      • Circuit fracture or disruption
      • System or component failure
      • Air embolus
      • Circuit clotting
      • Cannula issues

 

 

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