Patients requiring extracorporeal membrane oxygenation (ECMO) often become totally dependent on t... more Patients requiring extracorporeal membrane oxygenation (ECMO) often become totally dependent on the mechanical life support. The Extracorporeal Life Support Organization (ELSO) reports 2486 incidents of mechanical complications in 5905 ECMO supports. To help decrease the number of mechanical complications, an active quality assurance program was initiated at our institution. This resulted in identification of only 14 incidents of mechanical complications in 100 patients (neonate, pediatric, adult, and cardiac). Techniques for dealing with problems such as loss of roller pump occlusion, changing out of the membrane lung or heat exchanger without interrupting ECMO support, venous air lock, tamponade, emergency transfusion, and other situations were generated into written policies and procedures. We routinely review and practice problem solving techniques with specific emphasis on monitoring patient hemodyanmics and appearance. We conclude that written policies and procedures, “water d...
Patients requiring extracorporeal membrane oxygenation (ECMO) often become totally dependent on t... more Patients requiring extracorporeal membrane oxygenation (ECMO) often become totally dependent on the mechanical life support. The Extracorporeal Life Support Organization (ELSO) reports 2486 incidents of mechanical complications in 5905 ECMO supports. To help decrease the number of mechanical complications, an active quality assurance program was initiated at our institution. This resulted in identification of only 14 incidents of mechanical complications in 100 patients (neonate, pediatric, adult, and cardiac). Techniques for dealing with problems such as loss of roller pump occlusion, changing out of the membrane lung or heat exchanger without interrupting ECMO support, venous air lock, tamponade, emergency transfusion, and other situations were generated into written policies and procedures. We routinely review and practice problem solving techniques with specific emphasis on monitoring patient hemodynamics and appearance. We conclude that written policies and procedures, "water drills," and continuing education can be beneficial in early recognition, intervention, and/or prevention of ECMO mechanical complications.
To describe the equipment, personnel requirements, training, management techniques, and logistic ... more To describe the equipment, personnel requirements, training, management techniques, and logistic problems encountered in the design and implementation of a mobile extracorporeal membrane oxygenation (ECMO) program. This is a report of a technique for the transport of patients on ECMO and a description of our retrospective case series. The study was conducted at a regional referral children's hospital and ECMO unit. Thirteen neonatal medical patients with acute respiratory failure were transported with mobile-ECMO. Over a 24-month period, we transported 13 neonatal patients with mobile-ECMO. The reason for transport with mobile-ECMO was inability to convert from high-frequency ventilation (4 of 13), patient already on ECMO (1 of 13), and patient deemed too unstable for conventional transport (8 of 13). Eleven of the 13 patients were transported from other ECMO centers. Of the 13, 9 survived. No major complications during transport were reported for any of the patients. Follow-up ...
Critical care nursing clinics of North America, 1995
Mobile extracorporeal membrane oxygenation (ECMO) is being offered by select ECMO centers in the ... more Mobile extracorporeal membrane oxygenation (ECMO) is being offered by select ECMO centers in the United States. Mobile ECMO can be performed for the critically ill patient who is unable to be transported by conventional ambulance transport. This article discusses the logistics and safety considerations associated with mobile ECMO.
Patients requiring extracorporeal membrane oxygenation (ECMO) often become totally dependent on t... more Patients requiring extracorporeal membrane oxygenation (ECMO) often become totally dependent on the mechanical life support. The Extracorporeal Life Support Organization (ELSO) reports 2486 incidents of mechanical complications in 5905 ECMO supports. To help decrease the number of mechanical complications, an active quality assurance program was initiated at our institution. This resulted in identification of only 14 incidents of mechanical complications in 100 patients (neonate, pediatric, adult, and cardiac). Techniques for dealing with problems such as loss of roller pump occlusion, changing out of the membrane lung or heat exchanger without interrupting ECMO support, venous air lock, tamponade, emergency transfusion, and other situations were generated into written policies and procedures. We routinely review and practice problem solving techniques with specific emphasis on monitoring patient hemodyanmics and appearance. We conclude that written policies and procedures, “water d...
Patients requiring extracorporeal membrane oxygenation (ECMO) often become totally dependent on t... more Patients requiring extracorporeal membrane oxygenation (ECMO) often become totally dependent on the mechanical life support. The Extracorporeal Life Support Organization (ELSO) reports 2486 incidents of mechanical complications in 5905 ECMO supports. To help decrease the number of mechanical complications, an active quality assurance program was initiated at our institution. This resulted in identification of only 14 incidents of mechanical complications in 100 patients (neonate, pediatric, adult, and cardiac). Techniques for dealing with problems such as loss of roller pump occlusion, changing out of the membrane lung or heat exchanger without interrupting ECMO support, venous air lock, tamponade, emergency transfusion, and other situations were generated into written policies and procedures. We routinely review and practice problem solving techniques with specific emphasis on monitoring patient hemodynamics and appearance. We conclude that written policies and procedures, "water drills," and continuing education can be beneficial in early recognition, intervention, and/or prevention of ECMO mechanical complications.
To describe the equipment, personnel requirements, training, management techniques, and logistic ... more To describe the equipment, personnel requirements, training, management techniques, and logistic problems encountered in the design and implementation of a mobile extracorporeal membrane oxygenation (ECMO) program. This is a report of a technique for the transport of patients on ECMO and a description of our retrospective case series. The study was conducted at a regional referral children's hospital and ECMO unit. Thirteen neonatal medical patients with acute respiratory failure were transported with mobile-ECMO. Over a 24-month period, we transported 13 neonatal patients with mobile-ECMO. The reason for transport with mobile-ECMO was inability to convert from high-frequency ventilation (4 of 13), patient already on ECMO (1 of 13), and patient deemed too unstable for conventional transport (8 of 13). Eleven of the 13 patients were transported from other ECMO centers. Of the 13, 9 survived. No major complications during transport were reported for any of the patients. Follow-up ...
Critical care nursing clinics of North America, 1995
Mobile extracorporeal membrane oxygenation (ECMO) is being offered by select ECMO centers in the ... more Mobile extracorporeal membrane oxygenation (ECMO) is being offered by select ECMO centers in the United States. Mobile ECMO can be performed for the critically ill patient who is unable to be transported by conventional ambulance transport. This article discusses the logistics and safety considerations associated with mobile ECMO.
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Papers by Lorrie Baker