afely managing an ECMO patient requires a special level of compulsiveness and thoroughness. This is the responsibility of everyone caring for an ECMO patient including nurses, perfusionists, respiratory therapists, physicians, and surgeons. To help minimize errors and safety risks during shift change, a detailed checklist was developed to help facilitate communication and ensure that all equipment is functioning well.
The ECMO checklist is broken into two parts. The first involves communicating the patient’s condition and review of the data. The second phase, is a detailed inspection of the patient and equipment performed at the bedside.
It is useful to have a copy of the safety checklist and paper record as you perform the sign out so that the any findings can be documented immediately. This helps prevent forgetting items that can occur if the documentation is done later. I also recommend that the checklist be performed in a consistent pattern to help avoid missing items and help speed the process because everyone is familiar with the process.
Patient and Data Review
As with any ICU patient sign out, a lot of detailed and technical information needs to be conveyed as efficiently as possible. When the patient is ECMO, there is even more to think about and understand. So in addition, to routine data, special attention to ECMO parameters and data needs special attention.
ECMO Safety Data Review Checklist
- Patient’s condition and problem list.
- Vital signs and trends.
- Current infusions (eg. vasopressors, inotropes, maintenance fluid, tube feedings, sedation, etc).
- Flow settings and pump speed.
- Sweep gas flow rate and fraction delivered oxygen (FDO2).