Saving the Unsurvivable with En Route Extracorporeal Membrane Oxygenation
Abstract
Extracorporeal membrane oxygenation (ECMO) is an advanced medical technology used to treat respiratory and heart failure. The US military has used ECMO in the care of combat casualties during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) as well as in the treatment of patients during the recent COVID-19 pandemic. However, few Military Health System (MHS) personnel have training and experience in the use of ECMO therapy. To address this dearth of expertise, we developed and evaluated an accelerated ECMO course for military medical personnel. Fifty-one teams, each consisting of a physician and nurse or respiratory therapist, underwent a 5-hour accelerated ECMO course. Across three different phases, teams watched pre-recorded ECMO training lectures. Subjects then practiced priming the ECMO circuit, cannulating ECMO, initiating ECMO and correcting common complications on an ECMO simulation or live tissue model (LTM). Training success was evaluated via knowledge and confidence assessments, and observation of each team attempting to initiate ECMO on a Yorkshire swine patient model, transport the patient model, and troubleshoot complications with the support of telemedicine consultation when desired. Fifty-one teams successfully completed the course. All fifty-one teams (100 ) successfully primed the ECMO circuit. Of those, forty-eight teams (94.1 ) successfully initiated ECMO with an average time of 63 minutes. Additionally, forty-four teams (86.3 ) were able to convert to veno-arterial-venous VAV ECMO.
Document Details
- Document Type
- Technical Report
- Publication Date
- Dec 13, 2023
- Accession Number
- AD1228152
Entities
People
- Allyson A. Mireles
- Brannon Inmann
- Darren S. Baldwain
- Dylan C. Rodriguez
- Joseph K Maddry
- Kimberly L. Medellin
- Maria Castaneda
- Patrick C. Ng
- R Paredes
- William T Davis
Organizations
- 59th Medical Wing