ECMO Program Structure

*Advances in Extracorporeal Membrane Oxygenation - Volume 3*

[11] Schmid C, Philipp A, Hilker M, Rupprecht L, Arlt M, Keyser A, et al. Venovenous extracorporeal membrane oxygenation for acute lung failure in adults. The Journal of Heart and Lung Transplantation. 2012;**31**(1):9-15

[12] Tulman DB, Stawicki SPA, Whitson BA, Gupta SC, Tripathi RS, Firstenberg MS, et al. Veno-venous ECMO: A synopsis of nine key potential

challenges, considerations, and controversies. BMC: Anesthesiology.

[13] Firstenberg MS, Hanna JM. Introductory chapter: ECMO-growing

indications, applications, and

Available from: https://www.

indications-applications-and-

understanding of a complex supportive therapy. Advances in Extra-Corporeal Perfusion Therapies, IntechOpen. 2018. DOI: 10.5772/intechopen.81777.

intechopen.com/books/advances-inextra-corporeal-perfusion-therapies/ introductory-chapter-ecmo-growing-

understanding-of-a-complex-supportive

2014;**14**:65

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**Chapter 2**

**Abstract**

Patient

*and Ryan Szilagyi*

Nursing Implications in the ECMO

Effective care and positive outcomes of the extracorporeal membrane oxygenation (ECMO) patient necessitate optimal interdisciplinary management from the healthcare team, including expert care from specially trained registered nurses (RNs). It is incumbent upon the RN caring for the ECMO patient to excel in both time management and assessment skills, as this population often demands care delivery at the pinnacle of intensive care unit (ICU) acuity. Astute and nuanced monitoring of neurological status, bleeding risk with potential (often massive) transfusions, poor hemodynamics, and integrity of the ECMO pump itself are only the few specialized areas of focus that must share priority with traditional nursing considerations involving the critically ill, such as prevention of pressure injuries and bloodstream infections. These high-intensity medical foci must be balanced with ethical considerations, as the ultimate goal of returning the patient to their normal life is not always possible. These demands highlight the dynamic proficiency of the RN caring for the ECMO patient. The following chapter will highlight the importance of specialized nursing care in the critically ill patient supported with ECMO.

*Alex Botsch, Elizabeth Protain, Amanda R. Smith* 

**Keywords:** ECMO patient necessitates, interdisciplinary management,

The patient requiring extracorporeal membrane oxygenation (ECMO) for any etiology is almost always managed in the intensive care unit (ICU) and requires care around the clock, which is delivered by a collaboration of physicians, nurses (RNs), respiratory therapists, perfusionists, and many others. Close collaboration between care providers is crucial, particularly between the RN managing hemodynamic medication infusions and the ECMO specialist managing the pump. RNs provide extensive, holistic care for ICU patients and their families, much of it geared toward traditional, clinical care with the additional implications of ECMO therapy, which requires additional specialized training. Acuity, unpredictability, and heavy resource requirements of the ECMO patient, especially when initiating therapy, can necessitate unusual and innovative staffing models, which rely on flexibility and often extra hours and shifts to accommodate individual patient and unit needs. RNs are essential to the delivery of optimal healthcare and play an integral role in the care of patients admitted to the ICU, so it is important that, when staffed well, RNs reduce the risk of inhospital mortality anywhere from 14 to 36% [10, 29].

importance of specialized nursing care

**1. Introduction**
