HCSS Extracorporeal Membrane Oxygenation (ECMO) specialist/RRT

JOB SUMMARY:

This is a per diem position.

The term "ECMO Specialist" is defined for the purpose of these guidelines as "the technical specialist trained to manage the ECMO system and the clinical needs of the patient on ECMO under the direction and supervision of a licensed ECMO trained physician. The individual functioning as the ECMO Specialist should have a strong critical care background in neonatal, pediatric and/or adult critical care.

The Extracorporeal Membrane Oxygenation (ECMO) Specialist (ES) is responsible for ensuring appropriate patient care through the continuous monitoring and assessment of the ECMO circuit, related technology, and patient status. The incumbent identifies and corrects problems associated with the ECMO procedure and initiates and evaluates interventions consistent with protocol. The ES consults with the ECMO physician when patient condition and/or protocol limits or directives are in question. As a member of the ECMO team, this position works closely with other team members and health care providers to provide patient care in accordance with the patient’s individualized care plan.

MAJOR DUTIES / CRITICAL TASKS:   

The ES systematically and continuously collects and assesses data in collaboration with the ECMO team to provide therapeutic care for the patient and family.

·       Monitors and adjusts ECMO circuit settings (e.g. heat exchanger temperature, pump flow, sweep gas) to maintain parameters established by the ECMO physician.

·       Recommends administration of blood products, fluids, and/or medications as warranted by ECMO status.

·       Assesses the cardiopulmonary status of the patient through test results (e.g. ABGs, CBC, etc.) and physical assessment findings.

·       Performs patient assessment to anticipate and prevent potential problems (e.g. variances in blood pressure, perfusion, ventilation, and heart rate).

·       Monitors and manages intake and output records to ensure appropriate fluid levels.

·       Monitors coagulation results to assess clotting status; adjusts heparin infusion

per ECMO Heparin protocol.

·       Evaluates chest x-rays for endotracheal tube placement, cannulae position, and status of the lung fields in determining patient status and weaning guidelines; supports and maintains patency of the cannulae while patient is undergoing ECMO in collaboration with the ECMO physician.

·       Supports ECMO team research through the collection of ECMO-related data, preparation, and presentation of research abstracts and/or other documentation.

·       Demonstrates expertise in adult, neonatal, and/or pediatric care including patient assessment, technical skills, and psychosocial aspects of care.

·       Actively participates in the evaluation of new equipment. Effectively identifies and troubleshoots equipment problems.

The ES will participate as a member of the ECMO Team, working with the health care providers in providing quality care for the patient and their family.

·       Initiates multidisciplinary collaboration to positively impact the outcomes of care provided.

·       Collaborates with the ECMO physician and other health care providers involved in the management of the patient to coordinate all tests and evaluations (e.g. head and cardiac ultrasounds and EEGs) and provide care in accordance with the patient’s individualized care plan.

·       Recommends modifications in patient management to the ECMO physician based on the relationship between patient diagnosis and ECMO circuit and/or lab parameters.

·       Initiates steps to support and enhance the patient’s responsibility and self-determination in decision-making concerning health, treatment, and well-being.

·       Evaluates effectiveness of teaching interventions and patient/family level of understanding and adjusts teaching and plan of care

Communication

·       Participates in monthly interdisciplinary ECMO case reviews and in-services to share information and determine appropriateness of patient care plans.

·       Utilizes the ECMO flow sheet to maintain ongoing complete and detailed documentation of patient history and the amount of blood and other fluids

     administered and any complications that may occur.

·       Provides family/parental education and reinforces medical counseling initiated by the ECMO physician.

·       Provides a clear and concise end of shift report for oncoming ECMO Specialist regarding machine settings, patient status, and patient care plans.