More Certified Adult ECMO Specialist Knowledge Statements

More knowledge statements:

  1. can list the advantages of venovenous and venoarterial ECMO support
  2. understands the principles of left heart decompression, aortic afterload, and myocardial protection during ECMO support
  3. demonstrates an understanding medical gas blenders, connections, and gas administration
  4. is aware of ECC component specifications
  5. can apply the basic principles for troubleshooting the ECMO circuit
  6. can recognize and manage issues associated with loss of venous return during ECMO
  7. can describe pump/gas flow ECMO weaning techniques, managing ACT, and ventilatory changes during weaning, low-flow scenarios, and  trial offs
  8. describes the procedures for ECMO patient and circuit blood product administration
  9. understands issues for infection control for ECMO patients
  10. explains the principles for coagulation cascades, management of anticoagulation, control of clotting times, and disseminated intravascular coagulopathy for ECMO patients
  11. understands the methods for bedside and laboratory blood tests regarding ECMO patient management and the presence of coagulopathies
  12. assumes personal responsibility for continuous learning, and engaging in educational activities annually
  13. reviews and applies the local ECMO program policy and procedure manual, clinical practice guidelines, and ELSO guidelines
  14. can recognize hypotension/hypovolemia, hypertension, and cardiac arrest during ECMO support
  15. apply management principles for bleeding ECMO patients regarding blood product administration, control of bleeding and circuit surface blood interactions
  16. understands delivering and managing care to ECMO patients requiring CRRT
  17. can cite rated blood flow, priming volume, and pressure drops for ECC components
  18. can describe open and percutaneous cannulation procedures at the initiation of ECMO
  19. can cite indications, contraindications, risks, and benefits for venoarterial and venovenous ECMO support
  20. understands and lists ECMO patient fluid balance, electrolytes, and nutrition management issues
  21. understands issues for neurologic protection for ECMO patients
  22. understands and can complete ECMO circuit priming and de-airing methods
  23. can list clinical signs for pulmonary/cardiac recovery during ECMO support
  24. can recognize and manage venous or arterial air entrainment during ECMO
  25. understands delivering and managing care to ECMO patients requiring hemoconcentration
  26. understands and lists post ECMO complications such as platelet, coagulation, and electrolyte alterations
  27. can describe how to handle emergencies and complications including mechanical issues, circuit disruption. raceway rupture, system or component alarms and failures
  28. understands management of complex ECMO cases, possible surgery on ECMO, and post-operative bleeding
  29. can cite specifications for ECC pumps, oxygenators, and other components
  30. contributes to formal team meetings which include case reviews, updates on ECMO therapy, quality assurance, review of ECMO policy and procedures, administrative information
  31. knows team member responsibilities for pre-procedure notification of the ECMO team
  32. demonstrates an understanding of ventilator modalities and management
  33. can recognize and manage issues associated with ECMO roller pump head occlusion checks, and centrifugal pump complications such as pump stop scenarios and need for hand-cranking
  34. comprehends the applications of intra-aortic balloon pump and left ventricular assist (Impella) during ECMO
  35. comprehends the ethical and social issues, consent process, parental and family support, during the potential withdrawal of ECMO support
  36. can recite steps to emergently manage situations such as ECMO circuit raceway ruptures, heat exchanger failures, and need to change out membrane lungs and other components
  37. understands issues associated with sedation and pain control, seizures and cerebral protection during ECMO
  38. appreciates and can communicate the psychosocial aspects of ECMO support
  39. applies principles of management of intra- and inter-hospital transport on ECMO
  40. can recognize uncontrolled bleeding, intracranial and other cites for hemorrhage during ECMO
  41. can recognize and communicate issues during ECMO such as pneumothorax / pneumopericardium and hemothorax / hemopericardium
  42. understands personnel, medications required, complications, vessel ligation, and vessel reconstruction during ECMO decannulation
  43. completes current and valid basic life support certification
  44. appreciates and can cite milestones in the history of ECMO

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