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Looking For Input On Ecmo Transport, Fw/rw


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#1 AMason

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Posted 23 November 2015 - 10:53 PM

Hello all,

My program is working on ECMO transport with our local children's hospital (we are not hospital-based). We fly FW in a Lear 31A and RW in an EC135 and A109E. The facility will be providing the Cardiohelp device. Several other local hospitals are in the process of developing their own programs using the Cardiohelp and we anticipate the potential for more ECMO transport in the future. The idea is to transport surgeon and team to the referring, cannulate and then return the patient to the facility.

 

We do not currently have access to larger aircraft or the full resources that a hospital-based program offers (like Arkansas Children's or Michigan), so those comparisons are less useful.

 

What team configurations are people using?

What training did your flight crew receive?

Have you transported in a small/mid-sized RW? How did it work for you?

Have you partnered with a separate agency for ECMO services? How did you split the responsibilities?

 

Any other comments or suggestions are welcome.

 

Thanks!

Andrew


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#2 slb154

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Posted 10 July 2016 - 04:05 AM

We have been doing ECMO, Impella for several years and recently been having patients with both an ECMO and Impella devices placed.  Quite challenging transports for sure.  We use EC145's and use our transport team of 2 RN's and pick up a perfusionist and the ECMO and/or Impella device from our receiving facility.  The patients we get are already cannulated and we have to transfer for back for defintive care.  With the Impella our transport nurses manage the device. Normally a rep from the company is at the referring end to assist with transfer into the aircraft.  The ECMO the perfusionist manages the device the nurses manage the patient.  Still many growing pains with these transfers.  The numerous medicated drips, if the patient is on ventilator all creates a very stressful enviroment.  We also do them by ground, some of our referring facilities do have their own perfusionists and ECMO devices and prefer ground transport.  Logistically sometimes ground works better or if weather is an issue that has made us to them with ground services.   Hope some of that helps.  I would love to hear back what you ultimately come up with.  It such an evolving speciality within critical care transport.   Looking to collaborate to help improve our process as well.

 

Good luck Andrew!!!

 

Stephanie


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#3 mg/kg

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Posted 11 July 2016 - 01:29 PM

Hello all,

My program is working on ECMO transport with our local children's hospital (we are not hospital-based). We fly FW in a Lear 31A and RW in an EC135 and A109E. The facility will be providing the Cardiohelp device. Several other local hospitals are in the process of developing their own programs using the Cardiohelp and we anticipate the potential for more ECMO transport in the future. The idea is to transport surgeon and team to the referring, cannulate and then return the patient to the facility.

 

We do not currently have access to larger aircraft or the full resources that a hospital-based program offers (like Arkansas Children's or Michigan), so those comparisons are less useful.

 

What team configurations are people using?

What training did your flight crew receive?

Have you transported in a small/mid-sized RW? How did it work for you?

Have you partnered with a separate agency for ECMO services? How did you split the responsibilities?

 

Any other comments or suggestions are welcome.

 

Thanks!

Andrew

Andrew,

 

       One of the biggest issues I have seen in the past with any change in the scope of the program, such as adding IABP, NICU, or ECMO transports/retrievals, is the lack of practicing the logistics of the transport. I am specifically referring to getting crews comfortable with packaging, loading, and unloading the pt from the aircraft or ambulance. These details are often over looked as personnel are often more focused on the medical management. Not that medical management is not important, but if you end up with a huge rats nest of lines and tubing, you will find that it complicates the care. These are already high acuity low volume transports and anything you can do to lessen the cognitive load on the crews is a must.

 

      What I found works well was doing real world simulation. Actually going to facilities and picking up a mock pt with all the tubes/lines/drains/etc in place and loading them in to and out of the aircraft will help identify problems and hopefully will allow for the development of a solution or plan. I believe Jeff STAT in Philly did this and actually did a presentation on how they prepared for it at CCTMC this year.

 

Mike


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