Complete competencies on one ECLS pump system prior to first solo deployment.
Complete competencies on Cardiohelp and at least one variety of a component system pump within the first 3 months of employment.
Verbalize an understanding of the differences in VA and VV ECMO and different cannulation strategies for each.
Verbalize the effects that changes in native cardiac output has on VV and VA ECMO.
Demonstrate a complete circuit check and verbalize the significance of the findings and potential concerns.
Make appropriate adjustments to blood flow as directed and anticipate the changes in pressure and flow variables being monitored.
Verbalize the significance of monitoring SvO2.
Interpret ABGs and make appropriate sweep changes based on standard sweep calculation as directed.
Recognize changes in venous, pre-oxygenator, post-oxygenator and delta pressures and verbalize the significance, possible concerns or complications and potential causes.
Activate and set appropriate alarms on any pump to which they’ve been oriented.
Properly identify alarms and respond appropriately.
Identify the effects and potential causes of changes in preload and afterload.
Verbalize two situations when it is appropriate to hand crank.
Demonstrate how to use a hand crank properly or switch to a backup pump (Centrimag) on any piece of equipment to which they’ve been oriented.
Recognize venous air and respond appropriately.
Demonstrate safe removal of arterial air.
Recognize two types of oxygenator failure and make appropriate recommendations.
Demonstrate the ability to zero transducers and flush pigtails as needed.
Demonstrate how to change a cracked pigtail and/or stopcock safely and efficiently.
Demonstrate how to make temperature changes on any heater/cooler system.
Recognize and troubleshoot heater failure and take appropriate actions.
Verbalize and demonstrate the appropriate actions for an accidental decannulation of an arterial, venous and dual lumen cannula.
Verbalize a basic understanding of native blood flow through an adult heart, lungs and aorta, including the 3 common aortic branches.
Verbalize a basic understanding of the coagulation process, anti-coagulation drugs and the associated laboratory tests used.
Verbalize a basic knowledge of ventilator modes, strategies and the relationship to the ECLS system.
Verbalize a basic understanding of the benefits and risks of sedation, neuromuscular blockers and cooling.