Ecmo.icu

When to think about ECMO

WebThere is widespread uptake of ECMO into intensive care medicine practice despite limited high-level evidence showing a survival benefit. Providing temporal organ support in …

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URL: https://ecmo.icu/clinical-application-of-ecmo-when-to-think-about-ecmo/

Anticoagulation & bleeding – Alfred ECMO Guideline

WebAnticoagulation targets are adjusted from 50-70 (60-80) downwards according to risk. If bleeding is a real concern, a low dose of 500 U/hr without measurable anticoagulant …

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Pressure area care – Alfred ECMO Guideline

WebPressure area care. Safe pressure area care is essential during ECMO support and should be performed at usual frequencies (every 2 hours) in all ECMO patients. This can not be …

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Diagnostic and therapeutic procedures – Alfred ECMO Guideline

WebAny central access device in an ECMO patient follows the routine requirements to minimise the risk of central line associated bloodstream infections. Specific considerations in the …

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ECMO Initiation – Alfred ECMO Guideline

WebPlace a ECMO clamp on the ECMO circuit (immediately post oxygenator), return RPM knob to zero and silence alarms. This is the final clamp to be removed after patient connection …

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Temperature management – Alfred ECMO Guideline

WebTarget temperature management post cardiac arrest. 36°C as per standard, adjust heater temperature accordingly to achieve the aim. This is very achievable and should be …

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Specific Immediate Management – Alfred ECMO Guideline

WebImmediate Care in ED. Routine care immediately after initiating support includes: Distal perfusion cannula should be inserted as soon as time allows, max 4 hrs post cannulation …

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Air Embolism – Alfred ECMO Guideline

WebAir Embolism. Definition. Entry of air in the circuit and potentially the patient. Emergency intervention. Immediate. Clamp circuit ideally closest possible to the patient near the …

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Management – daily care – Alfred ECMO Guideline

WebDisclaimer and GDPR notice. This guideline is in clinical use at the Alfred Hospital, in the context of the experience and processes in place there.

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Change of configuration – Alfred ECMO Guideline

WebConversion to high-flow ECMO . High flow ECMO configuration may be considered in both VA and VV ECMO configurations. It involves using two different access cannulae to …

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End of life care – Alfred ECMO Guideline

WebTake a pre -oxygenator gas for Hb and pre-oxygenator oxygen saturation [SpO 2 preox] Calculation 2x 1.34 x Hb (in g/L) x (1-SpO2preox) x ECMO blood flow in L = ml/min fresh …

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Extubation and tracheostomy – Alfred ECMO Guideline

WebExtubation in VA ECMO. Extubation is a desirable aim in a patient on VA ECMO even fairly early in the course of their disease avoiding sedation, respiratory complication and …

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COVID-19 Pandemic – Alfred ECMO Guideline

WebThe current Alfred ECMO Guideline provides criteria for the application of ECMO for virally triggered lung injury. This guideline takes into account the interaction between disease, …

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Nursing overview – Alfred ECMO Guideline

WebStart of Shift Nursing Checklists must be performed after admission, at the start of each shift and on return from intra-hospital transport. ECMO Documentation requires hourly entry …

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VV ECMO Ward Round V6

WebThis checklist can be used for the daily ward round for the ICU patient on VV ECMO. For further details see the Alfred ECMO guideline. 1. Is ECMO support adequate? ⃝ Yes. ⃝ No. ⃝ …

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Antimicrobials – Alfred ECMO Guideline

WebAttention to aseptic technique during ECMO cannulation and commencement is vital, as is ongoing meticulous care of the cannula insertion sites, including minimising bleeding and …

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CT Imaging – Alfred ECMO Guideline

WebCT Imaging. Overview. Step 1 CT request. Step 2 Area of interest – type of scan. Step 3 Joint decision on the contrast delivery and modification of ECMO flow. Step 4 Contrast …

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CRRT and plasmapheresis connection – Alfred ECMO Guideline

WebECMO trained bedside ICU nurses carry out the connection and disconnection of CRRT from the ECMO circuit. CRRT connection must always be sited on the positive pressure …

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VAD Emergencies – Alfred ECMO Guideline

WebCardiac arrest. HM 3 shut down. This is only to be undertaken in the setting of palliation. VAD Controller/Pump. Cessation of Therapy. Controller will alarm during this process – …

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Pump Failure – Alfred ECMO Guideline

WebThis is failure of either the drive console or pump head to drive the centrifugal pump and create forward circuit blood flow. ECMO support will stop. Effects. VA ECMO: if the …

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ECPR Role Cards – Alfred ECMO Guideline

WebECPR Role Cards. Ideally, all 12 roles are allocated in the Emergency and Trauma Centre (E&TC). They can be grouped as the team leader, the ALS providing team and the …

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