More knowledge statements:
- can list the advantages of venovenous and venoarterial ECMO support
- understands the principles of left heart decompression, aortic afterload, and myocardial protection during ECMO support
- demonstrates an understanding medical gas blenders, connections, and gas administration
- is aware of ECC component specifications
- can apply the basic principles for troubleshooting the ECMO circuit
- can recognize and manage issues associated with loss of venous return during ECMO
- can describe pump/gas flow ECMO weaning techniques, managing ACT, and ventilatory changes during weaning, low-flow scenarios, and trial offs
- describes the procedures for ECMO patient and circuit blood product administration
- understands issues for infection control for ECMO patients
- explains the principles for coagulation cascades, management of anticoagulation, control of clotting times, and disseminated intravascular coagulopathy for ECMO patients
- understands the methods for bedside and laboratory blood tests regarding ECMO patient management and the presence of coagulopathies
- assumes personal responsibility for continuous learning, and engaging in educational activities annually
- reviews and applies the local ECMO program policy and procedure manual, clinical practice guidelines, and ELSO guidelines
- can recognize hypotension/hypovolemia, hypertension, and cardiac arrest during ECMO support
- apply management principles for bleeding ECMO patients regarding blood product administration, control of bleeding and circuit surface blood interactions
- understands delivering and managing care to ECMO patients requiring CRRT
- can cite rated blood flow, priming volume, and pressure drops for ECC components
- can describe open and percutaneous cannulation procedures at the initiation of ECMO
- can cite indications, contraindications, risks, and benefits for venoarterial and venovenous ECMO support
- understands and lists ECMO patient fluid balance, electrolytes, and nutrition management issues
- understands issues for neurologic protection for ECMO patients
- understands and can complete ECMO circuit priming and de-airing methods
- can list clinical signs for pulmonary/cardiac recovery during ECMO support
- can recognize and manage venous or arterial air entrainment during ECMO
- understands delivering and managing care to ECMO patients requiring hemoconcentration
- understands and lists post ECMO complications such as platelet, coagulation, and electrolyte alterations
- can describe how to handle emergencies and complications including mechanical issues, circuit disruption. raceway rupture, system or component alarms and failures
- understands management of complex ECMO cases, possible surgery on ECMO, and post-operative bleeding
- can cite specifications for ECC pumps, oxygenators, and other components
- contributes to formal team meetings which include case reviews, updates on ECMO therapy, quality assurance, review of ECMO policy and procedures, administrative information
- knows team member responsibilities for pre-procedure notification of the ECMO team
- demonstrates an understanding of ventilator modalities and management
- 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
- comprehends the applications of intra-aortic balloon pump and left ventricular assist (Impella) during ECMO
- comprehends the ethical and social issues, consent process, parental and family support, during the potential withdrawal of ECMO support
- 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
- understands issues associated with sedation and pain control, seizures and cerebral protection during ECMO
- appreciates and can communicate the psychosocial aspects of ECMO support
- applies principles of management of intra- and inter-hospital transport on ECMO
- can recognize uncontrolled bleeding, intracranial and other cites for hemorrhage during ECMO
- can recognize and communicate issues during ECMO such as pneumothorax / pneumopericardium and hemothorax / hemopericardium
- understands personnel, medications required, complications, vessel ligation, and vessel reconstruction during ECMO decannulation
- completes current and valid basic life support certification
- appreciates and can cite milestones in the history of ECMO
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